Optic nerve sheath diameter measurement: a means of detecting raised ICP in adult traumatic and non-traumatic neurosurgical patients

Fatal Autochthonous Hepatitis E Induced Acute on Chronic Liver Failure Presenting with Multiorgan Failure in a Non-endemic Country: Brief Review of Intensive Care Unit Management

“…In our case, POCUS allowed us to rule out other treatable causes of shock and detect a potentially raised ICP prior to the patient's demise. Raised ICP is transmitted to the subarachnoid space, which surrounds the optic nerve, causing optic nerve expansion and, as such, is translated as an increase in optic nerve diameter [14]. Recent studies confirm that ONSD measurement correlates with ICP measurements; with one study quoting ONSD measurement having 94.4% sensitivity and 95.2% specificity in traumatic brain injury patients [14][15].…”

“…Raised ICP is transmitted to the subarachnoid space, which surrounds the optic nerve, causing optic nerve expansion and, as such, is translated as an increase in optic nerve diameter [14]. Recent studies confirm that ONSD measurement correlates with ICP measurements; with one study quoting ONSD measurement having 94.4% sensitivity and 95.2% specificity in traumatic brain injury patients [14][15]. Given the potential complications of invasive ICP monitoring in coagulopathic patients and its varied availability in different regions, this may warrant a prospective trial on the use of optic nerve ultrasound in acute liver failure.…”

Pearls & Oy-sters: Diagnosis and monitoring of elevated intracranial pressure through ultrasound of the optic nerve

“…On the other hand, measurement of ONSD through bedside ultrasound can be done with minimal risk to the patient. [2][3][4][5] Furthermore, measurement of ONSD with bedside ultrasound has low intraobserver and interobserver variability, making this examination valuable when invasive means of monitoring are not available. 6 It also avoids some of the challenges associated with the bedside funduscopic examination, which is often limited by bright lights, patient instability, and lack of pupillary dilation.…”

Neurologic Complications and Neuromonitoring on ECMO

“…It is a simple bedside test used to detect elevated intracranial pressure. A cut-off of 5.2 mm is sensitive and specific for intracranial hypertension [68]. Its use in © 2019 The Author(s).…”