Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury

Geeraerts, Thomas; Launey, Yoann; Martin, Laurent; Pottecher, Julien; Vigué, Bernard; Duranteau, Jacques; Benhamou, Dan

doi:10.1007/s00134-007-0797-6

Cited by 407 publications

(351 citation statements)

References 31 publications

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“…4 Previous studies have shown high levels of correlation between optic nerve sheath width by ultrasonography and intracranial pressure measured directly through invasive monitors. [11][12][13] A study by Neudorfer et al 14 showed that increased optic nerve sheath width by orbital ultrasonography correlated well with the final diagnosis of papilledema or pseudopapilledema in a pediatric population. Our study aims to further evaluate the role of orbital ultrasonography in distinguishing papilledema from pseudopapilledema in a cohort of adult patients who were referred to the neuroophthalmology service for the evaluation of swollen optic nerves.…”

Section: Introductionmentioning

confidence: 99%

The role of orbital ultrasonography in distinguishing papilledema from pseudopapilledema

Carter

Pistilli

Livingston

et al. 2014

Eye

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Purpose To determine the sensitivity and specificity of orbital ultrasonography in distinguishing papilledema from pseudopapilledema in adult patients. Methods The records of all adult patients referred to the neuro-ophthalmology service who underwent orbital ultrasonography for the evaluation of suspected papilledema were reviewed. The details of history, ophthalmologic examination, and results of ancillary testing including orbital ultrasonography, MRI, and lumbar puncture were recorded. Results of orbital ultrasonography were correlated with the final diagnosis of papilledema or pseudopapilledema on the basis of the clinical impression of the neuro-ophthalmologist. Ultrasound was considered positive when the optic nerve sheath diameter was Z3.3 mm along with a positive 301 test. Results The sensitivity of orbital ultrasonography for detection of papilledema was 90% (CI: 80.2-99.3%) and the specificity in detecting pseudopapilledema was 79% (CI: 67.7-90.7%). Conclusions Orbital ultrasonography is a rapid and noninvasive test that is highly sensitive, but less specific in differentiating papilledema from pseudopapilledema in adult patients, and can be useful in guiding further management of patients in whom the diagnosis is initially uncertain.

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Section: Introductionmentioning

confidence: 99%

The role of orbital ultrasonography in distinguishing papilledema from pseudopapilledema

Carter

Pistilli

Livingston

et al. 2014

Eye

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“…Optic nerve sonography (US) has been used to identify intracranial hypertension through the measurement of the optic nerve sheath diameter (ONSD) [1,2]. Different US studies showed that an increased intracranial pressure (ICP) of different aetiologies leads to enlargement of the ONSD [3,4].…”

Section: Introductionmentioning

confidence: 99%

Sonography of the optic nerve sheath beyond the hyperacute stage of intracerebral hemorrhage

Lochner¹,

Mader²,

Nardone

et al. 2014

J Ultrasound

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Purpose To evaluate the feasibility and utility of serial measuring of the optic nerve sheath diameter beyond the hyperacute and acute stage of intracerebral hemorrhage (ICH). Methods Four patients with extensive ICH in the left basal ganglia were followed using ultrasound (US) and cerebral CT scans. Results Optic nerve sheath diameter values assessed beyond the acute stage of ICH showed a high correlation (q = 0.84, p = 0.0022) with midline shift of the third ventricle seen on CT scans. Conclusions Optic nerve sonography can be useful to evaluate patients with extensive ICH beyond the acute stage and help monitoring clinical evolution in these patients, when ICP monitoring is not feasible.Keywords Cerebral computed tomography Á Intracerebral hemorrhage Á Intracranial pressure Á Optic nerve sheath diameter Riassunto Obiettivi Valutare l 0 utilità clinica della misurazione seriale del diametro del nervo ottico e dei suoi rivestimenti dopo la fase acuta dell 0 emorragia cerebrale. Metodi Quattro pazienti con emorragia cerebrale sono stati sottoposti ad ecografia del nervo ottico e tomografia assiale computerizzata (TAC) del cranio. Risultati I valori del diametro del nervo ottico e dei suoi rivestimenti correlavano in maniera marcata con lo shift della linea mediana del terzo ventricolo evidenziato alla TAC cerebrale. Conclusioni La sonografia del nervo ottico con la misurazione del diametro del nervo ottico e dei suoi rivestimenti potrebbe costituire un utile strumento nel valutare l'evoluzione clinica dei pazienti con estesa emorragia intracranica, qualora la misurazione della pressione intracranica non fosse eseguibile.

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“…Noninvasive ICP Monitoring A variety of methods to measure ICP noninvasively have been studied, including transcranial Doppler ultrasonography [17,18], optic nerve sheath diameter [19][20][21], fundoscopic papillary examination [22], and tympanic membrane displacement [23]. Unfortunately, all of these techniques are subject to artifact, have been studied in relatively small numbers of patients, require significant expertise to perform, and have only limited correlation with invasively obtained ICPs.…”

Section: Invasive Icp Monitoringmentioning

confidence: 99%

ICU Management of Traumatic Brain Injury

Hallman

Joffe

2013

Curr Anesthesiol Rep

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Traumatic brain injury (TBI) is a major cause of death and disability throughout the world. Injury can be divided into primary and secondary injuries. For patients with TBI admitted to the intensive care unit (ICU), the management and prevention of secondary injury is most important. The third edition of the Brain Trauma Foundation guidelines was published in 2007 and is widely used to guide treatment of patients with severe TBI. This article reviews ICU care of patients with severe TBI, with a particular focus on recent evidence that is not incorporated in the existing guidelines.

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Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury

Abstract: In the early posttraumatic period, ocular ultrasound scans may be useful for detecting high ICP after severe TBI.

Cited by 407 publications

References 31 publications

The role of orbital ultrasonography in distinguishing papilledema from pseudopapilledema

The role of orbital ultrasonography in distinguishing papilledema from pseudopapilledema

Sonography of the optic nerve sheath beyond the hyperacute stage of intracerebral hemorrhage

ICU Management of Traumatic Brain Injury

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