Optic Nerve Sheath Diameter Measured by Point‐of‐Care Ultrasound and MRI

Shokoohi, Hamid; Pyle, Matthew; Kuhl, E; Loesche, Michael A.; Goyal, Arun; LeSaux, Maxine; Boniface, Keith; Taheri, M. Reza

doi:10.1111/jon.12764

Cited by 11 publications

(2 citation statements)

References 23 publications

(72 reference statements)

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“…ONSD is a promising adjunct for patient care. With MRI‐based and sonographically measured ONSD being comparable, 3 , 26 , 27 this tool might help assess an estimation of ICP without the need for multiple MRI scans. Thus, patients with GBM and urgent need for intervention due to assumed increased ICP might be identified early.…”

Section: Discussionmentioning

confidence: 99%

Retrospective longitudinal assessment of optic nerve sheath diameter in patients with malignant glioma

Feucht,

Kerscher,

Ruff

et al. 2023

Cancer Medicine

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IntroductionGlioblastoma (GBM) is a tumor with rapid growth and a possible relationship to elevated intracranial pressure (ICP). High ICP may not always be associated with clinical signs. A non‐invasive technique for assessment of ICP is measuring the optic nerve sheath diameter (ONSD). Identifying patients who need immediate intervention is of importance in neuro‐oncological care. The goal of this study is to assess the available magnetic resonance imaging (MRI) of patients with GBM with respect to pre‐ and postoperative ONSD.Methods and MaterialsRetrospective data analysis was performed on all patients operated for GBM at a tertiary care center between 2010 and 2020. Two pre and one postoperative MRI had to be available. Clinical data and ONSD at multiple time points were analyzed and correlated, as well as preoperative volumetrics.ResultsSixty‐seven patients met the inclusion criteria. Clinical signs of elevated ICP were seen in 25.4% (n = 17), while significant perifocal edema was present in 67.2% (n = 45) of patients. Clinical signs of preoperatively elevated ICP were associated with significantly elevated ONSD at diagnosis (p < 0.001) as well as preoperative tumor volume (p < 0.001). Significant perifocal edema at the time of diagnosis was associated with elevated ONSD (p = 0.029) and higher tumor volume (p = 0.003). In patients with significant edema, ONSD increased significantly between preoperative MRIs (p = 0.003/005). In patients with clinical signs of raised ICP, ONSD also increased, whereas it was stable in asymptomatic patients (yes: 5.01+/−4.17 to 5.83+/−0.55 mm, p = 0.010, no: 5.17+/−0.46 mm to 5.38+/−0.41 mm, p = 0.81). A significant increase of ONSD from diagnosis to preoperative MRI and a significant decrease until 3 months postoperatively were observed (p < 0.001).ConclusionsONSD might help identify high ICP in patients with GBM. In this first‐of‐its kind study, we observed a significant increase of ONSD preoperatively, likely associated with edema. Postoperatively, ONSD decreased significantly until 3 months after surgery and increased again at 12 months. Further prospective data collection is warranted.

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Section: Discussionmentioning

confidence: 99%

Retrospective longitudinal assessment of optic nerve sheath diameter in patients with malignant glioma

Feucht,

Kerscher,

Ruff

et al. 2023

Cancer Medicine

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“…This modality is not without its controversies like common artifact interfering with measurements and difficulty in training even experienced providers to identify ONS [ 59 ]. Inferior and transverse ocular scans yield the best images, and despite only moderate correlation with MRI measurements, the relative size can be used as a cursory examination [ 60 ]. Despite these challenges, protocols are being developed to standardize these examinations, [ 61 ] and this technique continues to be pursued in other areas of anesthesia care specifically obstetric anesthesiology [ 62 , 63 ].…”

Section: Trans-ocular Sonography For Elevated Icpmentioning

confidence: 99%

Point-of-Care Ultrasound for the Trauma Anesthesiologist

Heinz

Vincent

2022

Curr Anesthesiol Rep

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Purpose of Review With advances in technology and availability of handheld ultrasound probes, studies are focusing on the perioperative care of patients, but a limited number specifically on trauma patients. This review highlights recent findings from studies using point of care ultrasound (POCUS) to improve the care of trauma patients. Recent Findings Major findings include the use of POCUS to assess volume status of trauma patients upon arrival to measure the major vasculature. Additionally, several studies have advanced the use of POCUS to identify pneumothorax in trauma patients. Finally, the ASA POCUS certification and ASRA expert guidelines are examples of international organizations establishing guidelines for utilization and training of anesthesiologists in the field of POCUS, which will be discussed. Summary Despite the COVID-19 pandemic, and considerable resources being diverted to fight this global healthcare crisis, advances are being made in utilization of POCUS to aid the care of trauma patients.

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