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Ultrasonic Assessment of Optic Nerve Sheath to Detect Increased Intracranial Pressure.
J Med Ultrasound 2019 Apr-Jun; 27(2):69-74JM

Abstract

Purpose

Increased intracranial pressure (ICP) is one of the prevalent symptoms of trauma, especially traumatic headache, which requires quick action for the diagnosis and treatment. The optic nerve sheath diameter (ONSD) is a newly proposed technique for the detection of an increase in ICP. The aim of this study was to assess the efficacy of this new diagnostic method in patients with increased ICP induced by trauma.

Methods

This prospective study was conducted between December 2016 and February 2017. The patients with traumatic headache and who had been diagnosed with increased ICP using clinical signs and computed tomography scan were compared to the voluntary healthy group. In each patient, measurements were performed employing ultrasound three times on each eye in an axial region, and the mean of these sizes was obtained as the ONSD.

Results

A total of 112 participants were examined. The mean ONSD measurement of the patients and the voluntary healthy group was 6.01 ± 0.76 and 3.41 ± 0.56 mm in the right eye, 6.11 ± 0.75 and 3.39 ± 0.54 mm in the left eye, and 6.06 ± 0.75 and 4.02 ± 1.07 mm in both sides, respectively. The ONSD in the right and left sides had high and significant correlation in the patients (r = 0.929, P < 0.000) and voluntary healthy (r = 0.630, P < 0.000) group. The mean ONSD of one of the patients was 6.24 ± 0.56 mm, and in another patient with no clinical sign of increased ICP, the mean ONSD was 4.61 ± 0.09 mm.

Conclusions

Ultrasound performed on the diaphragm of the optic nerve with acceptable sensitivity can detect patients with an increase in ICP and can be efficacious in expediting the action needed to reduce ICP. Due to the sensitivity and specificity of the ultrasound and high accuracy of the diameter of optic nerve sheath in detecting increase in ICP, as well as considering the fact that ultrasound is a noninvasive and available technique; it can be performed at the patient's bedside.

Authors+Show Affiliations

Department of Radiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.Department of Radiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31316215

Citation

Hanafi, Mohammad Ghasem, et al. "Ultrasonic Assessment of Optic Nerve Sheath to Detect Increased Intracranial Pressure." Journal of Medical Ultrasound, vol. 27, no. 2, 2019, pp. 69-74.
Hanafi MG, Verki MM, Parei SN. Ultrasonic Assessment of Optic Nerve Sheath to Detect Increased Intracranial Pressure. J Med Ultrasound. 2019;27(2):69-74.
Hanafi, M. G., Verki, M. M., & Parei, S. N. (2019). Ultrasonic Assessment of Optic Nerve Sheath to Detect Increased Intracranial Pressure. Journal of Medical Ultrasound, 27(2), pp. 69-74. doi:10.4103/JMU.JMU_54_18.
Hanafi MG, Verki MM, Parei SN. Ultrasonic Assessment of Optic Nerve Sheath to Detect Increased Intracranial Pressure. J Med Ultrasound. 2019;27(2):69-74. PubMed PMID: 31316215.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ultrasonic Assessment of Optic Nerve Sheath to Detect Increased Intracranial Pressure. AU - Hanafi,Mohammad Ghasem, AU - Verki,Mohammadreza Maleki, AU - Parei,Sima Norouzi, Y1 - 2019/02/25/ PY - 2018/04/27/received PY - 2018/06/20/accepted PY - 2019/7/19/entrez PY - 2019/7/19/pubmed PY - 2019/7/19/medline KW - Intracranial pressure KW - optic nerve sheath KW - traumatic brain injury KW - ultrasound SP - 69 EP - 74 JF - Journal of medical ultrasound JO - J Med Ultrasound VL - 27 IS - 2 N2 - Purpose: Increased intracranial pressure (ICP) is one of the prevalent symptoms of trauma, especially traumatic headache, which requires quick action for the diagnosis and treatment. The optic nerve sheath diameter (ONSD) is a newly proposed technique for the detection of an increase in ICP. The aim of this study was to assess the efficacy of this new diagnostic method in patients with increased ICP induced by trauma. Methods: This prospective study was conducted between December 2016 and February 2017. The patients with traumatic headache and who had been diagnosed with increased ICP using clinical signs and computed tomography scan were compared to the voluntary healthy group. In each patient, measurements were performed employing ultrasound three times on each eye in an axial region, and the mean of these sizes was obtained as the ONSD. Results: A total of 112 participants were examined. The mean ONSD measurement of the patients and the voluntary healthy group was 6.01 ± 0.76 and 3.41 ± 0.56 mm in the right eye, 6.11 ± 0.75 and 3.39 ± 0.54 mm in the left eye, and 6.06 ± 0.75 and 4.02 ± 1.07 mm in both sides, respectively. The ONSD in the right and left sides had high and significant correlation in the patients (r = 0.929, P < 0.000) and voluntary healthy (r = 0.630, P < 0.000) group. The mean ONSD of one of the patients was 6.24 ± 0.56 mm, and in another patient with no clinical sign of increased ICP, the mean ONSD was 4.61 ± 0.09 mm. Conclusions: Ultrasound performed on the diaphragm of the optic nerve with acceptable sensitivity can detect patients with an increase in ICP and can be efficacious in expediting the action needed to reduce ICP. Due to the sensitivity and specificity of the ultrasound and high accuracy of the diameter of optic nerve sheath in detecting increase in ICP, as well as considering the fact that ultrasound is a noninvasive and available technique; it can be performed at the patient's bedside. SN - 0929-6441 UR - https://www.unboundmedicine.com/medline/citation/31316215/Ultrasonic_Assessment_of_Optic_Nerve_Sheath_to_Detect_Increased_Intracranial_Pressure L2 - http://www.jmuonline.org/article.asp?issn=0929-6441;year=2019;volume=27;issue=2;spage=69;epage=74;aulast=Hanafi DB - PRIME DP - Unbound Medicine ER -