Optic nerve sheath diameter by bedside ultrasound is a reliable screening test for cerebral edema in the comatose ICU patient

Mohamed, Ahmed Sh.; Alharbi, Nadia; Salahuddin, Nawal; Hussain, İqbal; Solaiman, Othman

doi:10.1186/cc14537

Cited by 4 publications

(3 citation statements)

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“…[19][20][21][22][23] ONSD has been utilized in evaluation of idiopathic intracranial hypertension, spontaneous intracranial hemorrhage, traumatic brain injuries, acute mountain sickness, cerebral edema, and brain death. [11,14,19,[24][25][26][27][28][29][30][31][32][33] ere have been contrasting studies on the utility of perioperative serial measurements of ONSD in patients undergoing elective craniotomy for intracranial tumor, with this research area being not well explored. Gao et al in their prospective and observational study raised concerns regarding value of ONSD in 33 patients after hemicraniectomy.…”

Section: Discussionmentioning

confidence: 99%

“…The cutoff value of sonographic ONSD which indicates raised ICP is a matter of debate. In a prospective and observational study of 43 patients by Mohammed et al ., [ 32 ] where ONSD was evaluated as a screening test in comatose ICU patients, a higher value of 5.8 mm was observed to be associated with cerebral edema, with a sensitivity of 86% and specificity of 74%. Moretti et al .…”

Section: Discussionmentioning

confidence: 99%

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Analysis of dynamic changes in optic nerve sheath diameter (ONSD) with ultrasound in post-craniotomy patients: Trends and correlation with computed tomography ONSD and Glasgow coma scale in post-operative period

Benhur

Sharma

Karna

et al. 2022

JNRP

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Objectives: Intracranial pressure (ICP) monitoring in patients with intracranial tumors undergoing craniotomy is usually done in perioperative period in intensive care unit. Invasive measurement of ICP, though considered as the gold standard, has its own limitations such as availability of expertise, equipment, and associated complications. Period of raised ICP in post-operative period may impact patient outcomes. Post-craniotomy computed tomography (CT) assessment is done routinely and may need to be repeated if indicated during post-operative stay. Utility of sonographic serial optic nerve sheath diameter (ONSD) assessment in post-operative monitoring of patients who have undergone elective craniotomy was explored in this study. The primary objective of the study was to measure the dynamic change in ONSD as compared to baseline pre-operative measurement in the first 3 postoperative days after elective craniotomy. The secondary objective of the study was to evaluate correlation between ONSD value with Glasgow Coma Scale (GCS) and post-operative CT findings. Materials and Methods: In this prospective, observational, and cohort study, we studied adult patients undergoing craniotomy for intracranial tumors. GCS assessment and sonographic measurement of ONSD were done preoperatively, immediate post-operative period, and 12, 24, and 48 h after surgery. CT scan to detect raised ICP was done at 24 h post-operative. Correlation of ONSD with GCS at respective period and correlation of CT scan finding with respective ONSD assessment were evaluated. Results: A total of 57 patients underwent elective craniotomy for intracranial tumors. Significant difference was observed in ONSD value depending on time of measurement perioperatively (χ2 = 78.9, P = 0.00). There was initial increase in the first 12 h followed by decrease in ONSD in the next 48 h. Negative correlation was observed between baseline ONSD and 12 h GCS (ρ = −0.345, P = 0.013). There was significant change in GCS scores based on the status of ONSD (raised or normal) at 12 h after surgery (P = 0.014). Significant correlation between USG ONSD and CT ONSD was observed (ρ = 0.928, P = 0.000). Optimal cutoff value of ONSD to detect raised ICP with reference to CT signs was 4.8 mm with 80% sensitivity and 95% specificity. Conclusion: ONSD undergoes dynamic changes, correlates with CT scan, and has good diagnostic accuracy to detect raised ICP post-craniotomy for intracranial tumors. It may serve as a useful tool in monitoring in resource-limited setup.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analysis of dynamic changes in optic nerve sheath diameter (ONSD) with ultrasound in post-craniotomy patients: Trends and correlation with computed tomography ONSD and Glasgow coma scale in post-operative period

Benhur

Sharma

Karna

et al. 2022

JNRP

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“…Pada penelitian yang dilakukan Kaur dkk, tahun 2020 menunjukan bahwa diameter selubung saraf optikus mempunyai hubungan yang signifikan dengan temuan CT Scan kepala pada pasien trauma kapitis dengan nilai p=0,000. 17 Pada penelitian Munawar dkk 18 , doi:10.24843.MU.2023.V12.i8.P17 menunjukan hubungan terbesar dalam diameter selubung saraf optikus ditemukan dengan cut-off >0,58 cm pada pasien dengan temuan CT Scan kepala positif .Pada penelitian Mohamed dkk, 19 tahun 2015 menunjukan hubungan antara diameter selubung saraf optikus dengan gambaran edema serebri pada pemeriksaan CT Scan .Pada penelitian Zoerle dkk., 20 tahun 2020 menunjukan tidak didapatkannya hubungan antara diameter selubung saraf optikus dengan perdarahan subdural.…”

Section: Pembahasanunclassified

Korelasi Ct Scan Kepala Dan Ultrasonografi Selubung Saraf Optik Dengan Skor Glasgow Coma Scale Pada Pasien Trauma Kapitis

Pramono,

Murtala,

Ilyas

2023

eum

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Peningkatan tekanan intrakranial merupakan suatu komplikasi pada pasien yang mengalami trauma kapitis. Peningkatan tekanan intrakranial dapat menyebabkan penurunan kesadaran hingga kematian. Glasgow coma scale (GCS) merupakan skala penilaian yang mempunyai tujuan sebagai penilaian kesadaran pasien. Pemeriksaan Computed Tomography (CT) Scan merupakan salah satu modalitas yang digunakan pada pasien trauma kapitis untuk melihat lesi intrakranial sebagai penyebab terjadinya peningkatan tekanan intrakranial. Ultrasonografi transokular dapat digunakan untuk mendeteksi peningkatan tekanan intrakranial. Perubahan diameter selubung saraf optik secara langsung disebabkan oleh perubahan peningkatan tekanan intrakranial. Penelitian ini merupakan penelitian cross sectional dengan subjek pasien didiagnosis dengan trauma kapitis yang dirujuk ke Instalasi Radiologi RSUP DR Wahidin SUdirohusodo untuk CT Scan kepala dan pemeriksaan USG transokuler dari bulan Juli sampai Desember 2021. Pada semua subjek penelitian dilakukan penilaian GCS, gambaran lesi intrakranial pada pemeriksaan CT Scan kepala dan pengukuran diameter selubung saraf optikus dengan pemeriksaan USG transokuler kemudian dilakukan analisa.Terdapat 32 subjek penelitian dengan trauma kapitis. Terdapat korelasi antara derajat kesadaran dan gambaran CT Scan kepala yakni variabel perdarahan intrakranial dan kompresi sisterna basal dengan nilai p masing-masing 0,045 (r=0,357) dan 0,005 (0,480) sedangkan variabel midline shift dan edema serebri tidak terdapat korelasi (p>0,05). Terdapat korelasi antara derajat kesadaran dan diameter selubung saraf optik dekstra dan sinistra dengan nilai p masing-masing 0,006 (r=-0,472) dan 0,011 (-0,442). Terdapat hubungan antara diameter selubung saraf optik dekstra dan sinistra dan gambaran CT Scan kepala yakni variabel midline shift, edema serebri dan kompresi sisterna basal (p<0,05) sedangkan variabel perdarahan intrakranial tidak terdapat hubungan (p>0,05). Kata kunci: CT Scan kepala, USG transokuler, GCS, trauma kapitis.

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Neurocritical Care of Mechanical Circulatory Support Devices

Shoskes

Whitman

Cho

2021

Curr Neurol Neurosci Rep

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Optic nerve sheath diameter by bedside ultrasound is a reliable screening test for cerebral edema in the comatose ICU patient

Cited by 4 publications

References 0 publications

Analysis of dynamic changes in optic nerve sheath diameter (ONSD) with ultrasound in post-craniotomy patients: Trends and correlation with computed tomography ONSD and Glasgow coma scale in post-operative period

Analysis of dynamic changes in optic nerve sheath diameter (ONSD) with ultrasound in post-craniotomy patients: Trends and correlation with computed tomography ONSD and Glasgow coma scale in post-operative period

Korelasi Ct Scan Kepala Dan Ultrasonografi Selubung Saraf Optik Dengan Skor Glasgow Coma Scale Pada Pasien Trauma Kapitis

Neurocritical Care of Mechanical Circulatory Support Devices

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