Non-invasive assessment of intracranial pressure using ocular sonography in neurocritical care patients

Abstract

all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40% of them through heads and faces, and 10% of them through trunks, cervical regions and other organs of the bodies. In the persons who were bitten by animals in the head region, the mean latency period for rabies was 33 days (SD = ±12.2 days), while the mean latency period in the persons who were bitten through hands and feet was 77 days (SD = ±45.8 days). The P value was <0.1. The results of this study showed that there is a significant reciprocal correlation between annual raining level and the frequency rate of animal bites in the province of Kerman (r = 0.5, P < 0.01). Conclusions According to this study, the role of foxes in the epidemiology of human rabies in the province of Kerman, located in the southeast of Iran, seems very important. Since most of the animal bite individuals, during the one-decade survey in this region of Iran, did not seem aware of the risk of exposure to the viral infection of rabies through animal bites, the public education of preventive measurements of rabies seems imperative by the public health authorities as well as vaccination of animals against rabies, especially dogs and cats, as well as mass vaccination of wild animals by means of distribution of oral vaccines in the vast and scattered forests by helicopters belonging to Veterinary Organization Authorities being recommended. Collaboration of intersectional public health relationships of medical science universities of the province of Kerman as well as all related authorities to control rabies prevalence in the regional and interregional provi...

Point-of-care Ocular Ultrasound to Detect Optic Disc Swelling

“…3 EP-performed POC US has already been shown to be a useful tool in the evaluation of other ocular pathology such as retinal detachment, vitreous hemorrhage, and lens dislocation, 4,5 and multiple studies have attempted to correlate sonographic evaluation of the retrobulbar optic nerve sheath with ICP measurements. [6][7][8][9] Because sonography is routinely available in the emergency department (ED) for other indications and can be performed quickly even in cases where traditional fundoscopy is difficult or impossible, this technique may be of significant value in the evaluation of patients at risk for conditions associated with optic disc swelling.…”

Comparison of ultrasonographic measurement of optic nerve sheath diameter (ONSD) versus direct measurement of intracranial pressure (ICP) in traumatic brain injury patients

“…(4) Direct measurement of ICP by intraventricular catheter is the gold standard and most confident method for detecting elevated ICP, but demands neurosurgical expertise. (2,5,6) For this reason, we need a method for diagnosing elevated ICP which is fast, confident and does not require the presence of a neurosurgeon. Such a method is ultrasonographic measurement of ONSD.…”

“…In this study we compared ultrasonographic measurement of ONSD with direct measurement of ICP and evaluated the correlation between ONSD and elevated ICP in traumatic brain injury patients. Most recent studies compa- (2,(6)(7)(8) In our study we used direct measurement of ICP by intraventricular catheter as a reference standard. This study points to a strong correlation between values of ICP measured by ICP catheter and ultrasonographic measurement of ONSD.…”

Application of Orbital Sonography in Neurology

“…Most authors suggest normal values < 5,0 mm for patients > 1 year (Ballantyne et al 2002;Blaivas et al 2003;Girisgin et al 2007;Helmke and Hansen 1996;Newman et al 2002;Tayal et al 2007;Tsung et al 2005). A reliable cut-off value to predict an ICP > 20cmH 2 O seems to be 5,7-6,0 mm with a sensitivity of 87-95% and a specificity of 79-100% (Geeraerts et al 2007;Geeraerts et al 2008;Soldatos et al 2008;Watanabe et al 2008). A meta-analysis of six studies having compared the reliability ONSD-measurements with classical invasive ICP monitoring in patients with intracranial hemorrhage and traumatic Fig.…”