Comparison of ultrasonographic measurement of optic nerve sheath diameter (ONSD) versus direct measurement of intracranial pressure (ICP) in traumatic brain injury patients
1,Department of Anesthesiology and Intensive Care University Hospital
DOI: 10.22514/SV61.042011.5 Vol.6,Issue 1,May 2011 pp.33-35
Published: 02 May 2011
Aim. To compare ultrasonographic measurement of optic nerve sheath diameter (ONSD) with direct measurement of intra-cranial pressure (ICP) and evaluate the correlation between them in traumatic brain injury patients.
Patients and methods. Twenty traumatic brain injury patients were enrolled in the study. Patients had a median Glasgow Coma Scale (GCS) score of 5. All patients underwent noninvasive measurement of ICP by ultrasonographic measurement of ONSD and invasive ICP measurement using an intraventricular catheter. We used MedCalc to analyze data.
Results. We compared the ONSD measurement in patients with ICP less than 20 cm H2O with patients with ICP greater than 20 cm H2O. The mean ONSD for 8 patients with ICP > 20 cmH2O was 7.6 +/- 0.8 mm, and for 18 patients with ICP < 20 cm H2O was 5.6 +/- 0.6 mm. Student t-test comparison between these two groups showed a statistically significant mean difference of 1.99 (95 % CI = 1.4-2.6). The ROC curve showed that the optimal cutoff value of ONSD for predicting ICP > 20 cm H2O was 6.1, with sensitivity of 100 % and specificity of 83 %. (the area under the curve was 0.98, 95 % CI = 0.825-0.990). In this study, the usually used cutoff of ONSD > 5 mm gives a sensitivity of 100 %, but a specificity of only 22 %. Conclusion. Ultrasonographic measurement of ONSD correlates with direct measurement of ICP. This method has potential as a screening test for elevated ICP in traumatic brain injury.
ultrasound, ONSD, ICP
MLADEN ŠIRANOVIĆ,TIHANA MAGDIĆ TURKOVIĆ,ALEKSANDAR GOPČEVIĆ,MIJO KELEČIĆ,NATAŠA KOVAČ,JOSIP KOVAČ,BOJAN RODE,MARINKO VUČIĆ. Comparison of ultrasonographic measurement of optic nerve sheath diameter (ONSD) versus direct measurement of intracranial pressure (ICP) in traumatic brain injury patients. Signa Vitae. 2011. 6(1);33-35.
1. Tayal VS, Neulander M, Norton HJ, Foster T, Saunders T, Blaivas M. Emergency department sonographic measurement of optic nerve sheath diameter to detect findings of increased intracranial pressure in adult head injury patients. Ann Emerg Med 2007 Apr;49(4):508-14.
2. Soldatos T, Chatzimichail K, Papathanasiou M, Gouliamos A. Optic nerve sonography: a new window for the non-invasive evaluation of intracranial pressure in brain injury. Emerg Med J 2009 Sep;26(9):630-4.
3. Karakitsos D, Soldatos T, Gouliamos A, Armaganidis A, Poularas J, Kalogeromitros A, et al. Transorbital sonographic monitoring of optic nerve diameter in patients with severe brain injury. Transplant Proc 2006 Dec;38(10):3700-6.
4. Blaivas M, Theodoro D, Sierzenski PR. Elevated intracranial pressure detected by bedside emergency ultrasonography of the optic nerve sheath. Acad Emerg Med 2003 Apr;10(4):376-81.
5. Goel RS, Goyal NK, Dharap SB, Kumar M, Gore MA. Utility of optic nerve ultrasonography in head injury. Injury 2008 May;39(5):519-24.
6. Geeraerts T, Merceron S, Benhamou D, Vigué B, Duranteau J. Non-invasive assessment of intracranial pressure using ocular sonography in neurocritical care patients.Intensive Care Med 2008 Nov;34(11):2062-7.
7. Kimberly HH, Shah S, Marill K, Noble V. Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure. Acad Emerg Med 2008 Feb;15(2):201-4.
8. Geeraerts T, Launey Y, Martin L, Pottecher J, Vigué B, Duranteau J, et al. Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury. Intensive Care Med 2007 Oct;33(10):1704-11.
9. Girisgin AS, Kalkan E, Kocak S, Cander B, Gul M, Semiz M. The role of optic nerve ultrasonography in the diagnosis of elevated intracranial pressure. Emerg Med J 2007 Apr;24(4):251-4.
10. Gangemi M, Cennamo G, Maiuri F, D'Andrea F Echographic measurement of the optic nerve in patients with intracranial hypertension. Neurochirurgia (Stuttg) 1987 Mar;30(2):53-5.
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