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Optic nerve sheath diameter based on preoperative brain computed tomography and intracranial pressure are positively correlated in adults with hydrocephalus.
Clin Neurol Neurosurg 2018; 167:31-35CN

Abstract

OBJECTIVE

The usefulness of optic nerve sheath diameter (ONSD) in predicting increased intracranial pressure (ICP) is not well established in adults with hydrocephalus. In this retrospective study, we evaluated the correlation between ONSD measured on brain computed tomography (CT) and ICP in adults with hydrocephalus.

PATIENTS AND METHODS

ONSDs were measured on preoperative brain CT images from 64 adult patients with hydrocephalus who underwent extracranial ventricular drainage or a ventriculoperitoneal shunt in 2016. ICP was defined as ventricular fluid pressure.

RESULTS

The ONSD measured on preoperative CT was greater in patients (n = 8) with a higher ICP (>20 mmHg, 5.8vs. 4.9 mm, P = 0.001). The ONSD was linearly correlated with ICP (r = 0.543, P < 0.001) and was predictive of increased ICP with an area under the receiver operating characteristic curve of 0.834. The optimal cut-off value of 5.3 mm ONSD yielded 88% sensitivity and 79% specificity. The inter-class coefficient of ONSD on preoperative CT was 0.882. The correlation between ONSD on preoperative CT and ICP was detected only in patients with communicating and non-communicating hydrocephalus (r = 0.437 and r = 0.585, P = 0.037 and P = 0.002, respectively).

CONCLUSION

ONSD measured on preoperative brain CT was linearly correlated with ICP in adult patients with communicating and non-communicating hydrocephalus, and it was a predictor of increased ICP with good discrimination and high inter-observer reliability. These results suggest that preoperative ONSD measurement on brain CT can be helpful to safely manage such patients by providing information about ICP.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: hppark@snu.ac.kr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29433056

Citation

Lee, Hyung-Chul, et al. "Optic Nerve Sheath Diameter Based On Preoperative Brain Computed Tomography and Intracranial Pressure Are Positively Correlated in Adults With Hydrocephalus." Clinical Neurology and Neurosurgery, vol. 167, 2018, pp. 31-35.
Lee HC, Lee WJ, Dho YS, et al. Optic nerve sheath diameter based on preoperative brain computed tomography and intracranial pressure are positively correlated in adults with hydrocephalus. Clin Neurol Neurosurg. 2018;167:31-35.
Lee, H. C., Lee, W. J., Dho, Y. S., Cho, W. S., Kim, Y. H., & Park, H. P. (2018). Optic nerve sheath diameter based on preoperative brain computed tomography and intracranial pressure are positively correlated in adults with hydrocephalus. Clinical Neurology and Neurosurgery, 167, pp. 31-35. doi:10.1016/j.clineuro.2018.02.012.
Lee HC, et al. Optic Nerve Sheath Diameter Based On Preoperative Brain Computed Tomography and Intracranial Pressure Are Positively Correlated in Adults With Hydrocephalus. Clin Neurol Neurosurg. 2018;167:31-35. PubMed PMID: 29433056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optic nerve sheath diameter based on preoperative brain computed tomography and intracranial pressure are positively correlated in adults with hydrocephalus. AU - Lee,Hyung-Chul, AU - Lee,Won-Jong, AU - Dho,Yun-Sik, AU - Cho,Won-Sang, AU - Kim,Yong Hwy, AU - Park,Hee-Pyoung, Y1 - 2018/02/07/ PY - 2017/12/07/received PY - 2018/01/11/revised PY - 2018/02/06/accepted PY - 2018/2/13/pubmed PY - 2018/2/13/medline PY - 2018/2/13/entrez KW - Brain computed tomography KW - Hydrocephalus KW - Intracranial pressure KW - Optic nerve sheath diameter SP - 31 EP - 35 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 167 N2 - OBJECTIVE: The usefulness of optic nerve sheath diameter (ONSD) in predicting increased intracranial pressure (ICP) is not well established in adults with hydrocephalus. In this retrospective study, we evaluated the correlation between ONSD measured on brain computed tomography (CT) and ICP in adults with hydrocephalus. PATIENTS AND METHODS: ONSDs were measured on preoperative brain CT images from 64 adult patients with hydrocephalus who underwent extracranial ventricular drainage or a ventriculoperitoneal shunt in 2016. ICP was defined as ventricular fluid pressure. RESULTS: The ONSD measured on preoperative CT was greater in patients (n = 8) with a higher ICP (>20 mmHg, 5.8vs. 4.9 mm, P = 0.001). The ONSD was linearly correlated with ICP (r = 0.543, P < 0.001) and was predictive of increased ICP with an area under the receiver operating characteristic curve of 0.834. The optimal cut-off value of 5.3 mm ONSD yielded 88% sensitivity and 79% specificity. The inter-class coefficient of ONSD on preoperative CT was 0.882. The correlation between ONSD on preoperative CT and ICP was detected only in patients with communicating and non-communicating hydrocephalus (r = 0.437 and r = 0.585, P = 0.037 and P = 0.002, respectively). CONCLUSION: ONSD measured on preoperative brain CT was linearly correlated with ICP in adult patients with communicating and non-communicating hydrocephalus, and it was a predictor of increased ICP with good discrimination and high inter-observer reliability. These results suggest that preoperative ONSD measurement on brain CT can be helpful to safely manage such patients by providing information about ICP. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/29433056/Optic_nerve_sheath_diameter_based_on_preoperative_brain_computed_tomography_and_intracranial_pressure_are_positively_correlated_in_adults_with_hydrocephalus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(18)30057-X DB - PRIME DP - Unbound Medicine ER -