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Ultrasonographic optic nerve sheath diameter Measurement for raised intracranial pressure in a Tertiary care centre of a developing country.
J Ayub Med Coll Abbottabad. 2018 Oct-Dec; 30(4):495-500.JA

Abstract

Background

Intracranial hypertension is not an uncommon life-threatening syndrome, caused by a variety of non-neurological and neurological illnesses, and quick diagnosis, timely treatment of Raised Intracranial Pressure (ICP) is associated with improved outcome. Our aim of study was to determine ultrasonographic measurement of Optic nerve sheath diameter (ONSD) for raised ICP.

Methods

Prospective case series done in Emergency and Paediatric critical care unit of Aga Khan University Hospital. ONSD measurement in millimetres was done by placing linear probe of ultrasound on eye ball.

Results

Forty-eight patients were included in study with mean age of 7.5±5.0 years with 21/48 (43.8%) between 1-8 years and 19/48 (39.6%) >8 years with 32/48 (66.7%) were male. Non-traumatic coma was most common diagnosis 41/48 (85.4%) with infectious cause being most common while Traumatic brain injury constitutes 7/48 (14.6%). Ct scan brain was done in 39/48 (81.3%) while MRI brain in rest of patients. Raised ICP was found in 83.33% (40/48) patients with Ultrasonographic ONSD measurement as compared to CT scan/MRI 14/48 (29.2%). 85% of patients, showed ultrasonographic ONSD measurement suggestive of Raised ICP with GCS ≤12. Mean ONSD with signs of raised ICP in infants 4.64 (±0.48), in 1-10 years 6.44 (±0.65), and in adolescent >10 years 6.28 (±0.62) ONSD respectively with ROC Curve showing Area Under Curve (AUC) 0.814 (95% CI, 0.692-0.936).

Conclusions

We identified threshold of Ultrasonographic ONSD measurement in infants >4.0 mm, in children 1-10 yrs >4.71 mm, in adolescent >10 yrs >5.43 mm for raised ICP with sensitivity and specificity of 100% and 60-66.7% respectively. 85% of patients showed raised ICP with Ultrasonographic ONSD measurement with GCS ≤12.

Authors+Show Affiliations

Department of Paediatric and Child Health, Karachi, Pakistan.Department of Paediatric and Child Health, Karachi, Pakistan.Department of Paediatric and Child Health, Karachi, Pakistan.Department of Paediatric and Child Health, Karachi, Pakistan.Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan.Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30632323

Citation

Rehman Siddiqui, Naveed Ur, et al. "Ultrasonographic Optic Nerve Sheath Diameter Measurement for Raised Intracranial Pressure in a Tertiary Care Centre of a Developing Country." Journal of Ayub Medical College, Abbottabad : JAMC, vol. 30, no. 4, 2018, pp. 495-500.
Rehman Siddiqui NU, Haque A, Abbas Q, et al. Ultrasonographic optic nerve sheath diameter Measurement for raised intracranial pressure in a Tertiary care centre of a developing country. J Ayub Med Coll Abbottabad. 2018;30(4):495-500.
Rehman Siddiqui, N. U., Haque, A., Abbas, Q., Jurair, H., Salam, B., & Sayani, R. (2018). Ultrasonographic optic nerve sheath diameter Measurement for raised intracranial pressure in a Tertiary care centre of a developing country. Journal of Ayub Medical College, Abbottabad : JAMC, 30(4), 495-500.
Rehman Siddiqui NU, et al. Ultrasonographic Optic Nerve Sheath Diameter Measurement for Raised Intracranial Pressure in a Tertiary Care Centre of a Developing Country. J Ayub Med Coll Abbottabad. 2018 Oct-Dec;30(4):495-500. PubMed PMID: 30632323.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ultrasonographic optic nerve sheath diameter Measurement for raised intracranial pressure in a Tertiary care centre of a developing country. AU - Rehman Siddiqui,Naveed Ur, AU - Haque,Anwarul, AU - Abbas,Qalab, AU - Jurair,Humaira, AU - Salam,Basit, AU - Sayani,Raza, PY - 2019/1/12/entrez PY - 2019/1/12/pubmed PY - 2019/2/28/medline KW - Optic nerve sheath diameter KW - Paediatric intensive care unit KW - Raised Intracranial Pressure KW - Ultrasonography SP - 495 EP - 500 JF - Journal of Ayub Medical College, Abbottabad : JAMC JO - J Ayub Med Coll Abbottabad VL - 30 IS - 4 N2 - Background: Intracranial hypertension is not an uncommon life-threatening syndrome, caused by a variety of non-neurological and neurological illnesses, and quick diagnosis, timely treatment of Raised Intracranial Pressure (ICP) is associated with improved outcome. Our aim of study was to determine ultrasonographic measurement of Optic nerve sheath diameter (ONSD) for raised ICP. Methods: Prospective case series done in Emergency and Paediatric critical care unit of Aga Khan University Hospital. ONSD measurement in millimetres was done by placing linear probe of ultrasound on eye ball. Results: Forty-eight patients were included in study with mean age of 7.5±5.0 years with 21/48 (43.8%) between 1-8 years and 19/48 (39.6%) >8 years with 32/48 (66.7%) were male. Non-traumatic coma was most common diagnosis 41/48 (85.4%) with infectious cause being most common while Traumatic brain injury constitutes 7/48 (14.6%). Ct scan brain was done in 39/48 (81.3%) while MRI brain in rest of patients. Raised ICP was found in 83.33% (40/48) patients with Ultrasonographic ONSD measurement as compared to CT scan/MRI 14/48 (29.2%). 85% of patients, showed ultrasonographic ONSD measurement suggestive of Raised ICP with GCS ≤12. Mean ONSD with signs of raised ICP in infants 4.64 (±0.48), in 1-10 years 6.44 (±0.65), and in adolescent >10 years 6.28 (±0.62) ONSD respectively with ROC Curve showing Area Under Curve (AUC) 0.814 (95% CI, 0.692-0.936). Conclusions: We identified threshold of Ultrasonographic ONSD measurement in infants >4.0 mm, in children 1-10 yrs >4.71 mm, in adolescent >10 yrs >5.43 mm for raised ICP with sensitivity and specificity of 100% and 60-66.7% respectively. 85% of patients showed raised ICP with Ultrasonographic ONSD measurement with GCS ≤12. SN - 1819-2718 UR - https://www.unboundmedicine.com/medline/citation/30632323/Ultrasonographic_optic_nerve_sheath_diameter_Measurement_for_raised_intracranial_pressure_in_a_Tertiary_care_centre_of_a_developing_country_ L2 - http://jamc.ayubmed.edu.pk/index.php/jamc/article/view/2968/2017 DB - PRIME DP - Unbound Medicine ER -