Sonographic Optic Nerve Sheath Diameter as an Estimate of Intracranial Pressure in Adult Trauma

A Unique Model for Ultrasound Assessment of Optic Nerve Sheath Diameter

“…The exact technique is based on that found in the literature [1][2][3][4][5] . A line perpendicular to the axis of the disc is drawn three millimeters behind the optic disc.…”

“…More recently, literature is emerging that increasingly confirms its correlation to standard invasive intracranial monitoring in order to better define its role in ICP determination [2][3][4][5][6][7][8][9][10][11][12] . To date, studies have supported the correlation of ONSD to ICP in neurocritically ill patients [4][5][6][7][8] , both adult and pediatric 9 .…”

Optic Nerve Ultrasound for the Detection of Raised Intracranial Pressure

“…Our study included the largest number of individual test subjects with acute brain injury (n = 65) as well as the largest number of individual correlations (n = 536) between measured ONSD and simultaneous invasive ICP monitoring currently in the literature. Studies that have included a small number of patients or correlations may be of questionable validity [18,19]. Most published studies of ONSD measurement that have included at least 30 direct correlations have demonstrated good correlation between ONSD and invasive ICP measurements [8][9][10][11][12][13].…”

Noninvasive methods of detecting increased intracranial pressure

“…On the other hand, one study found that although there was a correlation between ONSD and ICP, no single cutoff value could be used as a suitable diagnostic tool to predict ICP [38]. Another study of 10 adult trauma patients using a cutoff of 6.0 mm demonstrated 36 % sensitivity and 38 % specificity, and thereby concluded that ONSD measured by US is not a useful tool for predicting ICP [39]. Table 3 enumerates a list of ONSD studies, modality of measurement, cutoff values, and relevant statistics.…”