Optic Nerve Sheath Diameter: Correlation With Intra-Ventricular Intracranial Measurements in Predicting Dysfunctional Intracranial Compliance.

intracranial pressure optic nerve sheath diameter ultrasonography

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
30 Jan 2021
Historique:
entrez: 4 3 2021
pubmed: 5 3 2021
medline: 5 3 2021
Statut: epublish

Résumé

Background Ultrasonographic (USG) measurement of optic nerve sheath diameter (ONSD) has been proposed as a non-invasive, bedside method to detect raised intracranial pressure (ICP) in various clinical settings. We aimed to correlate the ONSD obtained from ultrasonography with the gold standard, intraventricular ICP, and to find out the cut-off point which predicts ICP accurately at different levels. Methodology A prospective double-blind study was carried out by performing ocular ultrasounds in 30 adult patients with features of intracranial hypertension. The ONSD was measured by USG intraoperatively along with direct intraventricular pressure measurement. The ONSD was compared with the intraventricular ICP and correlations were derived. The optimum cut-off of ONSD to predict ICP > 20 mm Hg, 25 mm Hg, 30 mm Hg, and 35 mm Hg was sought. Results There was a significant correlation of ONSD with ICP (r = 0.532, p = 0.002). An ONSD threshold of 5.5 mm predicted ICP > 20 mm Hg with high sensitivity (100%) and specificity (75%) (area under receiver operating characteristic [ROC] curve = 0.904, p=0.01). The optimum ONSD cut-off predicting ICP at values of 25 mm Hg, 30 mm Hg, and 35 mm Hg was 6.3 mm, 6.5 mm, and 6.7 mm, respectively. Conclusion Our study confirms the utility of optic nerve ultrasound in the diagnostic evaluation of patients with known or suspected intracranial hypertension. We recommend an ONSD cut-off of 5.5 mm for predicting ICP > 20 mm Hg.

Identifiants

pubmed: 33659139
doi: 10.7759/cureus.13008
pmc: PMC7919758
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e13008

Informations de copyright

Copyright © 2021, Sahu et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Seelora Sahu (S)

Anaesthesiology, Tata Main Hospital, Jamshedpur, IND.

Nidhi Panda (N)

Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.

Amlan Swain (A)

Anaesthesiology, Tata Main Hospital, Jamshedpur, IND.

Preethy Mathew (P)

Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.

Navneet Singla (N)

Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.

Sunil Gupta (S)

Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.

Kiran Jangra (K)

Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.

Avanish Bhardwaj (A)

Anaesthesiology and Critical Care, Command Hospital Airforce Bangalore, Bengaluru, IND.

Hemant Bhagat (H)

Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.

Classifications MeSH