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[Correlation of intracranial pressure and diameter of the sheath of the optic nerve by computed tomography in severe traumatic brain injury].

Abstract

BACKGROUND

Noninvasive techniques to evaluate intracranial pressure (ICP) are important for everyday practice in intensive care and neurosurgery departments. CT data can be used to evaluate the optic nerve sheath diameter (ONSD) and, indirectly, the ICP value. The ONSD value is an additional criterion in deciding on invasive monitoring of ICP.

AIM

To analyze a correlation between CT-based ONSD and the results of invasive measurements of ICP in patients with severe traumatic brain injury.

MATERIAL AND METHODS

The study evaluated 41 patients with severe traumatic brain injury within the first 48 h after injury. Invasive monitoring of ICP (Codman & Shurtlett, MA, USA) was performed during 7±1.7 days. ONSD was measured using axial CT scans (CereTom, Neurologica Danvers, MA, USA) with a slice thickness of 2.5 mm. The ONSD value was measured at a distance of 3 mm from the posterior eyeball contour. The patients were allocated in a group with normal ICP (10 patients) and a group with high ICP (31 patients). ONSD served as an ICP classifier. The data were processed using ROC analysis.

RESULTS

According to the CT data, the optimal threshold ONSD value was 6.35 mm in patients in the acute TBI period. The sensitivity was 0.93 (95% СI 0.84-1.00), the specificity was 0.80 (95% СI 0.50-1.00), and AUC was 0.87 (95% СI 0.69-1.00).

CONCLUSION

We found a correlation between the CT-based ONSD and the median ICP (R=0.32, p<0.05). An ONSD value of 6.35 mm and more is one of the signs of previous or existing ICP.

Authors+Show Affiliations

Burdenko Neurosurgical Institute, Moscow, Russia, 125047.Burdenko Neurosurgical Institute, Moscow, Russia, 125047.Burdenko Neurosurgical Institute, Moscow, Russia, 125047.Burdenko Neurosurgical Institute, Moscow, Russia, 125047.Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia, 127473.

Pub Type(s)

Journal Article

Language

rus

PubMed ID

29393290

Citation

Turkin, A M., et al. "[Correlation of Intracranial Pressure and Diameter of the Sheath of the Optic Nerve By Computed Tomography in Severe Traumatic Brain Injury]." Zhurnal Voprosy Neirokhirurgii Imeni N. N. Burdenko, vol. 81, no. 6, 2017, pp. 81-88.
Turkin AM, Oshorov AV, Pogosbekyan EL, et al. [Correlation of intracranial pressure and diameter of the sheath of the optic nerve by computed tomography in severe traumatic brain injury]. Zh Vopr Neirokhir Im N N Burdenko. 2017;81(6):81-88.
Turkin, A. M., Oshorov, A. V., Pogosbekyan, E. L., Smirnov, A. S., & Dmitrieva, A. S. (2017). [Correlation of intracranial pressure and diameter of the sheath of the optic nerve by computed tomography in severe traumatic brain injury]. Zhurnal Voprosy Neirokhirurgii Imeni N. N. Burdenko, 81(6), pp. 81-88. doi:10.17116/neiro201781681-88.
Turkin AM, et al. [Correlation of Intracranial Pressure and Diameter of the Sheath of the Optic Nerve By Computed Tomography in Severe Traumatic Brain Injury]. Zh Vopr Neirokhir Im N N Burdenko. 2017;81(6):81-88. PubMed PMID: 29393290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Correlation of intracranial pressure and diameter of the sheath of the optic nerve by computed tomography in severe traumatic brain injury]. AU - Turkin,A M, AU - Oshorov,A V, AU - Pogosbekyan,E L, AU - Smirnov,A S, AU - Dmitrieva,A S, PY - 2018/2/3/entrez PY - 2018/2/3/pubmed PY - 2018/4/18/medline KW - computed tomography KW - intracranial pressure KW - optic nerve sheath diameter KW - traumatic brain injury SP - 81 EP - 88 JF - Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko JO - Zh Vopr Neirokhir Im N N Burdenko VL - 81 IS - 6 N2 - BACKGROUND: Noninvasive techniques to evaluate intracranial pressure (ICP) are important for everyday practice in intensive care and neurosurgery departments. CT data can be used to evaluate the optic nerve sheath diameter (ONSD) and, indirectly, the ICP value. The ONSD value is an additional criterion in deciding on invasive monitoring of ICP. AIM: To analyze a correlation between CT-based ONSD and the results of invasive measurements of ICP in patients with severe traumatic brain injury. MATERIAL AND METHODS: The study evaluated 41 patients with severe traumatic brain injury within the first 48 h after injury. Invasive monitoring of ICP (Codman & Shurtlett, MA, USA) was performed during 7±1.7 days. ONSD was measured using axial CT scans (CereTom, Neurologica Danvers, MA, USA) with a slice thickness of 2.5 mm. The ONSD value was measured at a distance of 3 mm from the posterior eyeball contour. The patients were allocated in a group with normal ICP (10 patients) and a group with high ICP (31 patients). ONSD served as an ICP classifier. The data were processed using ROC analysis. RESULTS: According to the CT data, the optimal threshold ONSD value was 6.35 mm in patients in the acute TBI period. The sensitivity was 0.93 (95% СI 0.84-1.00), the specificity was 0.80 (95% СI 0.50-1.00), and AUC was 0.87 (95% СI 0.69-1.00). CONCLUSION: We found a correlation between the CT-based ONSD and the median ICP (R=0.32, p<0.05). An ONSD value of 6.35 mm and more is one of the signs of previous or existing ICP. SN - 0042-8817 UR - https://www.unboundmedicine.com/medline/citation/29393290/[Correlation_of_intracranial_pressure_and_diameter_of_the_sheath_of_the_optic_nerve_by_computed_tomography_in_severe_traumatic_brain_injury]_ L2 - https://www.mediasphera.ru/msph/en/neiro/artcl/VoprosyNeirokhirurgii_2017_06_081_EN.pdf DB - PRIME DP - Unbound Medicine ER -