Predictive Value of Optic Nerve Sheath Diameter for Diagnosis of Intracranial Hypertension in Children With Severe Brain Injury

Cour-Andlauer, Fleur; Portefaix, Aurélie; Wroblewski, I.; Rabilloud, Muriel; Bordet, Fabienne; Cogniat, Bérengère; Didier, Capucine; Pouyau, Robin; Valla, Frédéric V.; Kassaï-Koupaï, Behrouz; Siméon, Gaëlle; Ginhoux, Tiphanie; Courtil-Teyssedre, Sonia; Javouhey, Étienne

doi:10.3389/fped.2022.894449

Cited by 3 publications

(2 citation statements)

References 35 publications

(52 reference statements)

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“…The mean ONSD was also considerably greater (P 0.001) in patients with elevated ICP (group B), according to Mabrouk et al [21] . Contrary to our findings, Cour-Andlaue et al [22] came to the conclusion that axial ONSD measurement did not predict the 24-hour incidence of intracranial hypertension in children with severe brain damage. The severity of the trauma, timing, and circumstances of the measurements can all be used to explain this.…”

Section: Discussioncontrasting

confidence: 99%

Comparative study between ultrasound guided coronal versus axial optic nerve sheath diameter measurement in patients at risk of increased intracranial pressure

AlMobaiad,

Mohamed,

Okab

et al. 2023

Int. J. Med. Anesthesiology

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Background: This work intended to contrast the effectiveness as well as precision of ultrasound guided coronal versus axial optic nerve sheath diameter (ONSD) measurement in patients at danger of elevated intracranial pressure (ICP). The optic nerve is a tubular structure of approximately 5 cm in Length, in which its intraorbital segment is evaluable sonographically. Methods: The 70 patients in this prospective, randomised, double-blinded trial spanned in age from 18 to 60 and had moderately to grave traumatic brain injury (TBI) when they were transferred to the intensive care unit (ICU) with a GCS of 3-12. There were two groups of patients: Patients in Group A do not exhibit elevated ICP readings on brain CT scans. Group B: Patients who had elevated ICP found on a brain CT scan. Results: There were non-significant higher mean coronal ONSD in comparison to mean axial ONSD in both groups. significant higher mean ONSD and mean axial and coronal ONSD in patients of group B. The Glasgow Coma Scale (GCS) was considerably lower in group B patients. In addition, there was a substantial inverse correlation between the mean ONSD, mean coronal and axial ONSD (mm), and the GCS for patients in both categories. Conclusions: In patients with trauma to the brain, monitoring the diameter of the optic nerve sheath with bedside ocular ultrasonography is a beneficial non-invasive way to detect excessive intracranial pressure earlier and correlation via the two methods (axial and coronal) gives us more accurate measurements.

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Section: Discussioncontrasting

confidence: 99%

Comparative study between ultrasound guided coronal versus axial optic nerve sheath diameter measurement in patients at risk of increased intracranial pressure

AlMobaiad,

Mohamed,

Okab

et al. 2023

Int. J. Med. Anesthesiology

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“…A study of children indicated a sensitivity of 93% and a specificity of 74% in detecting increased ICPs with a threshold ONSD of 5.5 mm (subgroup threshold for infants <1 year 5.16 mm, and >1 year 5.75 mm), with excellent inter-rater reliability [ 199 , 200 ]. The control group in another study of children with TBI [ 201 ] showed a median ONSD of only 4.5 mm [4.1–4.8]. In another study, an ONSD > 4.5 mm was rated as abnormal [ 202 ].…”

Section: Approaches Of Non-invasive Measurementsmentioning

confidence: 99%

Non-Invasive Intracranial Pressure Monitoring

Müller

Henkes

Gounis³

et al. 2023

JCM

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(1) Background: Intracranial pressure (ICP) monitoring plays a key role in the treatment of patients in intensive care units, as well as during long-term surgeries and interventions. The gold standard is invasive measurement and monitoring via ventricular drainage or a parenchymal probe. In recent decades, numerous methods for non-invasive measurement have been evaluated but none have become established in routine clinical practice. The aim of this study was to reflect on the current state of research and shed light on relevant techniques for future clinical application. (2) Methods: We performed a PubMed search for “non-invasive AND ICP AND (measurement OR monitoring)” and identified 306 results. On the basis of these search results, we conducted an in-depth source analysis to identify additional methods. Studies were analyzed for design, patient type (e.g., infants, adults, and shunt patients), statistical evaluation (correlation, accuracy, and reliability), number of included measurements, and statistical assessment of accuracy and reliability. (3) Results: MRI-ICP and two-depth Doppler showed the most potential (and were the most complex methods). Tympanic membrane temperature, diffuse correlation spectroscopy, natural resonance frequency, and retinal vein approaches were also promising. (4) Conclusions: To date, no convincing evidence supports the use of a particular method for non-invasive intracranial pressure measurement. However, many new approaches are under development.

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Optic Nerve Ultrasound Evaluation in Children: A Review

et al. 2023

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Managing patients with neurocritical illness requires monitoring and treating elevated intracranial pressure (ICP), especially in cases in children. In terms of precise and real-time measurements, invasive ICP measurements are presently the gold standard for the initial diagnosis and follow-up ICP assessments. As a rapid and non-invasive way to detect elevated ICP, point-of-care ultrasonography (POCUS) of optic nerve sheath diameter (ONSD) has been proposed. The utility of bedside POCUS of ONSD to detect elevated ICP with excellent diagnostic test accuracy in adults has already been demonstrated. Nonetheless, data on the relationship between POCUS of ONSD and ICP in children are scarce. Therefore, the purpose of this review is to point out the most recent findings from the pediatric published literature and briefly discuss what was assessed with ONSD ultrasound examination, and also to describe and discuss the diagnostic procedures available for optic nerve ultrasound appraisal. A search of the medical databases PubMed and Scopus was carried out. The terms such as “ocular ultrasonography”, “ICP assessment”, “children”, “point-of-care ultrasound”, and “POCUS” were searched. In conclusion, the use of the standardized A-scan technique coupled with the B-scan technique should be suggested to provide data that are as accurate, precise, repeatable, and objective as possible.

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Predictive Value of Optic Nerve Sheath Diameter for Diagnosis of Intracranial Hypertension in Children With Severe Brain Injury

Cited by 3 publications

References 35 publications

Comparative study between ultrasound guided coronal versus axial optic nerve sheath diameter measurement in patients at risk of increased intracranial pressure

Comparative study between ultrasound guided coronal versus axial optic nerve sheath diameter measurement in patients at risk of increased intracranial pressure

Non-Invasive Intracranial Pressure Monitoring

Optic Nerve Ultrasound Evaluation in Children: A Review

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