Detection of Increased Intracranial Pressure by Ultrasound

Hightower, Stephanie; Chin, Eric J.; Heiner, Jason D.

doi:10.55460/50cd-9mjd

Cited by 13 publications

(3 citation statements)

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“…Third, in this study, operation times were less than 2 h. Hansen et al 11 said that prolonged surgical time‐related prolonged intracranial hypertension affected the reversibility of the ONSD changes but further are needed for confirmation. Lastly, a cut‐off value of ONSD is not well defined and may differ according to the typical characteristics of the population and race 15–17 . Therefore, the absence of an increase in ONSD cannot fully guarantee the safety of patients.…”

Section: Discussionmentioning

confidence: 99%

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The effect of pneumoperitoneum and Trendelenburg position on optic nerve sheath diameter in patients undergoing laparoscopic hysterectomy

Bayramov

Kılıçaslan

Akıncı

et al. 2022

J of Obstet and Gynaecol

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Background and Aim Laparoscopic hysterectomy (LH) have been frequently used because of low complication rates and short duration of hospital stay. Elevated intracranial pressure (ICP), a disadvantage of laparoscopic surgery, is caused by the Trendelenburg position (TP) and CO2 pneumoperitoneum (PP). This study aimed to evaluate TP and PP associated changes in ICP by ONSD measurements during LH. The intra‐and inter‐observer consistency and reliability of ONSD measurements were also investigated. Methods Sixty patients with were enrolled into this prospective study. ONSD for each patient was measured by three anesthesiologists at T0, T1, T2, and T3 time points. ONSD, mean arterial pressure (MAP), end tidal CO2 (EtCO2), and arterial blood CO2 partial pressure values (PaCO2) were measured at T0: baseline, T1: 10 min after introducing 20 mmHg PP, T2: 10 min after placing the patient in TP and 15 mmHg PP and, T3: 10 min after PP deflation. Results The ONSD measured at T1 (5.97 ± 0.49 cm) and T2 (5.95 ± 0.57 cm) were higher than T0 (5.63 ± 0.53 cm) and T3 (5.72 ± 0.47 cm) (p < 0.05). There were no correlations between MAP and ONSD, and also between PaCO2, EtCO2, and ONSD measurements at any time points. Inter‐observer intraclass correlation coefficient (ICC) values of ONSD measurements by all examiners had moderate (at T1) to good (at T0, T2, T3) reliability. Intra‐observer agreements were reasonable for each observer. Conclusion ONSD measurements increase with CO2PP and TP in patients undergoing LH. Transorbital sonography is a reliable method to monitor intraoperative changes in ONSDs. This study underlines the need for careful training and the importance of standardization in order to obtain reliable results in the examination technique of ONSD measurements.

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Section: Discussionmentioning

confidence: 99%

“…Lastly, a cut-off value of ONSD is not well defined and may differ according to the typical characteristics of the population and race. [15][16][17] Therefore, the absence of an increase in ONSD cannot fully guarantee the safety of patients.…”

Section: Limitations Of the Studymentioning

confidence: 99%

The effect of pneumoperitoneum and Trendelenburg position on optic nerve sheath diameter in patients undergoing laparoscopic hysterectomy

Bayramov

Kılıçaslan

Akıncı

et al. 2022

J of Obstet and Gynaecol

View full text Add to dashboard Cite

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“…Raised intracranial pressure (ICP), defined as cerebrospinal fluid (CSF) pressure of more or equal to 20 mm HG, can lead to adverse and often irreversible neurological consequence if untreated [6]. Raised ICP is seen frequently after a severe TBI [1], therefore early identification is critical to ensure timely and appropriate management [7]. To avoid complications of the ventriculostomy, the traditional and gold standard method of measuring ICP, non-invasive methods of estimating ICP are preferred whenever possible and optic nerve sheath diameter (ONSD) is increasingly utilized to indirectly assess ICP using ultrasonography [8], CT scan [9] and MRI [10].…”

Section: Introductionmentioning

confidence: 99%

Correlation between Optic Nerve Sheath Diameter and Marshall Scale in Acute Traumatic Brain Injury

Al-Tameemi,

Al-Essawi,

Alyassari

2023

CLINICMED

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Background: Imaging plays integral role in the evaluation of patients with acute traumatic brain injury (TBI), with computerized tomography (CT) being the modality of the choice and the most commonly utilized imaging tool. One of the important determinants of TBI severity is raised intracranial pressure (ICP). Optic nerve sheath diameter (ONSD) was considered as a reliable indirect surrogate for the raised ICP, however, studies assessing role of CT-derived ONSD in evaluation of patients with raised ICP or brain injury are limited. Aim of the study: To assess the correlation between ONSD measured by CT scan and the severity of TBI according to Marshall scale. Patients and methods: A cross-sectional analytic study was conducted on 60 adult patients (52 males, 8 females) presented with acute TBI and referred for brain CT examination. After initial general evaluation of brain CT images, the score of TBI was assessed according to Marshal's scale (I to VI). The transverse ONSD was manually measured on axial CT image at 3 mm distance behind eye globe. The correlation between the grade of TBI and ONSD was subjected to statistical analysis. The study was approved by the Institutional Ethical Review Committee. Results: The means of all, right-sided and left-sided ONSD were 4.695 mm, 4.606 mm and 4.785 mm respectively. There was positive, linear and statistically significant correlation (p value <0.001, r = 0.662) between the mean of ONSD measured by CT scan and Marshall score. When the ONSD measurements of the right and left sides were analyzed separately, the correlation was also significant and positive (r= 0.504 for the right side, r = 0.699 for the left side with p value <0.001 for both). ONSD showed weakly negative and statistically not significant correlation (p value= 0.571, r = - 0.075) with the duration between onset of the trauma and time of CT examination. There was no significant difference between mean ONSD measurements when correlated with the laterality of TBI, age or gender (p values 0.392 0.328 and 0.462 respectively). Conclusion: ONSD measured on brain CT scan is positively correlated with the severity of TBI as assessed by Marshall scale. Because Marshall scale has prognostic implication, ONSD may also have a prognostic value during assessment of patients with TBI.

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Eye (Ocular)

Jeong¹,

Chitturi²

2016

Practical Point-of-Care Medical Ultrasound

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Detection of Increased Intracranial Pressure by Ultrasound

Cited by 13 publications

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The effect of pneumoperitoneum and Trendelenburg position on optic nerve sheath diameter in patients undergoing laparoscopic hysterectomy

The effect of pneumoperitoneum and Trendelenburg position on optic nerve sheath diameter in patients undergoing laparoscopic hysterectomy

Correlation between Optic Nerve Sheath Diameter and Marshall Scale in Acute Traumatic Brain Injury

Eye (Ocular)

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