The diagnostic and prognostic value of the optic nerve sheath diameter on CT for diagnosis spontaneous subarachnoid hemorrhage

Yeşilaras, Murat; Kılıç, Turgay Yılmaz; Yesilaras, Suveyda; Atilla, Özge Duman; Oncel, Dilek; Çamlar, Mahmut

doi:10.1016/j.ajem.2017.04.022

Cited by 16 publications

(13 citation statements)

References 20 publications

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“…The widening of the perineural space surrounding the optic nerve and the corresponding increased ONSD values are secondary to the increased ICP and correlate with signs of cerebral hypertension detected using other neuroimaging techniques [21,22]. This finding is easily explained by the connection of the perineural space surrounding the optic nerve with the meninges of the central nervous system.…”

Section: Discussionmentioning

confidence: 83%

B-Mode Transorbital Ultrasonography for the Diagnosis of Idiopathic Intracranial Hypertension: A Systematic Review and Meta-Analysis

et al. 2018

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In patients with idiopathic intracranial hypertension (IIH), transorbital sonography (TOS) may reveal an enlargement of the optic nerve sheath diameter (ONSD) and the presence of optic disc elevation (ODE), as a sign of an increase in intracranial pressure (ICP). We systematically reviewed the TOS findings in adults with IIH. MEDLINE, EMBASE, Cochrane Library and CENTRAL (1966 – May 2017) were searched to identify studies reporting data on patients with IIH assessed by B mode-TOS. Data were extracted and included in a meta-analysis, and the quality of the included studies was evaluated. 5 studies with 96 patients were included. The values of ODE were 0.8 – 1.2 mm and ONSD was 6.2 – 6.76 mm in IIH patients vs. 4.3 – 5.7 mm in controls. In IIH patients the ONSD was significantly higher compared to controls (overall weighted mean difference of 1.3 mm (95 % CI: 0.6 – 1.9 mm)). The meta-analysis of proportion of papilledema based on results of three studies revealed a pooled estimator of 87 % (95 % CI: 76 – 94 %). IIH patients have higher ONSD values and higher frequency of ODE compared to controls. The indirect, noninvasive ICP assessment using TOS may be useful in supporting the clinical diagnosis of IIH in adults by detecting increased ONSD values and the presence of ODE.

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Section: Discussionmentioning

confidence: 83%

B-Mode Transorbital Ultrasonography for the Diagnosis of Idiopathic Intracranial Hypertension: A Systematic Review and Meta-Analysis

et al. 2018

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“…Correlation between ONSD and ICP has been shown many times in both adult and pediatric studies. [12,[14][15][16]20,21] Many pathologies, such as diabetic ketoacidosis, anesthetic drug usage, hydrocephalus, could increase the ONSD by increasing the ICP. [22,23] Correlations between RCTS and ONSD have been shown in a previous study for adult traumatic brain injury, and measures above 5.8 mm for ONSD have been determined for severe TBI for adults.…”

Section: Discussionmentioning

confidence: 99%

Correlation between optic nerve sheath diameter (ONSD) and Rotterdam computer tomography scoring in pediatric brain injury

Kayadibi

Tekerek

Yeşilbaş

et al. 2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Pediatric head trauma is the most common presentation to emergency departments. Increased intracranial pressure (ICP) may lead to secondary brain damage in head trauma and early diagnosis of increased ICP is very important. Measurement of optic nerve sheath diameter (ONSD) is a method that can be used for determining increased ICP. In this study, we aimed to evaluate the relationship between optic nerve sheath diameter (ONSD) and Rotterdam computer tomography scores (RCTS) in pediatric patients for severe head trauma. METHODS: During January 2017-April 2018, medical records and imaging findings of children aged 0-18 years who underwent computed tomography (CT) imaging for head trauma (n=401) and non-traumatic (convulsions, respiratory disorders, headache) (n=255) complaints, totally 656 patient were evaluated retrospectively. Patients' age, sex, presentation and trauma type (high energy-low energy) were identified. Non-traumatic patients with normal cranial CT findings were considered as the control group. CT findings of traumatic brain injury were scored according to Rotterdam criteria. Patients were divided into groups according to their age as follows: 0-3 years, 3-6 years, 6-12 years and 12-18 years. RESULTS: In our study, tomographic reference measurements of the ONSD in pediatric cases were presented according to age. There was a statistically significant difference between ONSD of severe traumatic patients and the control group. Correlation between RCTS and ONSD was determined and age-specific cutoff values of ONSD for severe traumatic scores (score 4-5-6) were presented. CONCLUSION: In our study, reference ONSDs of the pediatric population for CT imaging was indicated. Our study also showed that ONSD measurement is a parameter that can be used in addition to the RCTS to determine the prognosis of the patient in severe head trauma, by reflecting increased intracranial pressure.

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“…Shirodkar et al found a positive correlation between ocular ultrasonography and magnetic resonance imaging of ONSD [16]. In turn, Yesilaras et al indicated that in patients with spontaneous subarachnoid haemorrhage (SAH), the optic nerve sheath diameter measured in the orbital sections of a non-contrast head computed tomography is strongly correlated with a SAH diagnosis [17]. Badamoe Zeiler et al [18] suggests a significant finite learning curve associated with ONSD measurements.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound assessment of the optic nerve sheath as an indirect method of diagnosis of increased intracranial pressure

Ruetzler

Dudek

Dunder

et al. 2019

Disaster Emerg Med J

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Ultrasonography is a diagnostic technique that has been used clinically for 30 years. Due to the increased availability of ultrasound machines as well as the reduction of their size and making them more mobile, ultrasound has found its place in early diagnosis in emergency medicine settings. One of the important, however, an underestimated ultrasound examination is the measurement of the thickness of the optic nerve sheath. The optic nerve is the second cranial nerve, meaning the same sheath surrounds it as the brain. At the moment of intracranial pressure increase, cerebrospinal fluid flows into the subarachnoid space causing an increase in intracranial pressure and thus increasing the diameter of the optic nerve sheath. therefore, ONSD imaging is a quick non-invasive test aimed at detecting and monitoring changes in intracranial pressure. Optic nerve sheath ultrasound is a simple, safe and inexpensive bedside diagnostic test. Ophthalmic ultrasound usually uses the frequency between 5 and 10.5 MHz to evaluate the eye and the orbit.

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The diagnostic and prognostic value of the optic nerve sheath diameter on CT for diagnosis spontaneous subarachnoid hemorrhage

Cited by 16 publications

References 20 publications

B-Mode Transorbital Ultrasonography for the Diagnosis of Idiopathic Intracranial Hypertension: A Systematic Review and Meta-Analysis

B-Mode Transorbital Ultrasonography for the Diagnosis of Idiopathic Intracranial Hypertension: A Systematic Review and Meta-Analysis

Correlation between optic nerve sheath diameter (ONSD) and Rotterdam computer tomography scoring in pediatric brain injury

Ultrasound assessment of the optic nerve sheath as an indirect method of diagnosis of increased intracranial pressure

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