Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0041-1740174
Correlation between the Optic Nerve Sheath Diameter Measurement and Intracranial Hypertension Tomographic Findings from a Colombian Hospital
Correlação entre a medição do diâmetro da bainha do nervo óptico e os achados tomográficos da hipertensão intracraniana em um hospital colombiano Funding Sources The present research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.![](https://www.thieme-connect.de/media/10.1055-s-00028832/202204/lookinside/thumbnails/10-1055-s-0041-1740174_2100042-1.jpg)
Abstract
Objective In the present study, we aimed at determining the correlation between tomographic findings of intracranial hypertension and ultrasound measurement of the optic nerve sheath diameter (ONSD).
Methods Observational, descriptive, prospective, cross-sectional pilot study. The present research was performed in a tertiary hospital in Cali, Colombia, from March 2019 to October 2019. Twenty-five patients constituted the intracranial hypertension group, and 25 patients without intracranial hypertension constituted the control group. Ultrasound measurements of the ONSD were assessed using a Sonosite Turbo (SonoSite Inc., Bothell, WA, USA) ultrasound. The computed tomography (CT) images obtained from each patient diagnosed with intracranial hypertension were available in the software of the hospital. The primary outcome was the ultrasound measurement of the ONSD.
Results The ONSD values of the right eye of the intracranial hypertension group ranged from 5.2 to 7.6 mm, and the ONSD of the left eye ranged from 5.3 to 7.3 mm. The global ONSD values, obtained from the average between the right and left eye, were recorded between 5.25 and 7.45 mm. Overall, our study indicated that ultrasound measurements of the ONSD were effective in differentiating a group with intracranial hypertension, previously diagnosed by CT scan images, from patients without this condition. According to the ROC curve, the optimal cutoff point for detecting intracranial hypertension was 5.2 mm.
Conclusions Ultrasound measurements of the ONSD correlated with the measurements obtained from CT scan images, suggesting that the ultrasound technique can be efficient in identifying patients with intracranial hypertension and valuable in cases when CT scan images are not an available option.
Resumo
Objetivo No presente estudo, pretendemos determinar a correlação entre os achados tomográficos da hipertensão intracraniana e a medida ultrassonográfica do diâmetro da bainha do nervo óptico (DBNO).
Métodos Estudo piloto, observacional, descritivo, prospectivo e transversal. A presente pesquisa foi realizada em um hospital terciário de Cali, na Colômbia, de março de 2019 a outubro de 2019. Vinte e cinco pacientes fizeram parte do grupo de hipertensão intracraniana e 25 pacientes sem hipertensão intracraniana fizeram parte do grupo controle. O ultrassom Sonosite Turbo (SonoSite Inc., Bothell, WA, EUA) foi utilizado para a medição ultrassonográfica do DBNO. As imagens tomográficas computadorizadas obtidas de cada paciente com diagnóstico de hipertensão intracraniana estavam disponíveis no software do Hospital. O resultado primário foi a medida ultrassonográfica do DBNO.
Resultados Os valores de DBNO do olho direito do grupo de hipertensão intracraniana foram de 5,2 a 7,6 mm e o DBNO do olho esquerdo foi de 5,3 a 7,3 mm. No que se refere aos valores globais de DBNO obtidos a partir da média entre o olho direito e o olho esquerdo, registrou-se entre 5,25 e 7,45mm. No geral, o presente estudo indicou que as medições ultrassonográficas do DBNO foram eficazes na diferenciação de um grupo com hipertensão intracraniana, previamente diagnosticada por imagens de tomografia computadorizada (TC), de pacientes sem essa condição. De acordo com a curva ROC, o ponto de corte ideal para detectar hipertensão intracraniana foi de 5,2 mm.
Conclusões De acordo com nossos achados, as medidas ultrassonográficas do ONSD se correlacionaram com as medidas obtidas nas imagens de TC, sugerindo que a técnica ultrassonográfica pode ser eficiente para identificar pacientes com hipertensão intracraniana e útil nos casos em que as imagens tomográficas não são uma opção disponível.
Palavras-chave
Nervo Óptico - Hipertensão Intracraniana - Ultrassonografia - Tomografia Computadorizada por Raios XInformed Consent and Patient Details
The authors declare that the present report does not contain any personal information that could identify the patient(s) or volunteers.
Presentation
Preliminary data for the present study were presented as an abstract European Anaesthesiology Congress 2020. European Journal of Anaesthesiology. 2020;37(e-Supplement 58):191
Ethics
The Institutional Committee for the Review of Human Ethics of the Universidad del Valle (Cali, Colombia) on February 28, 2019, gave the ethical approval for the present study (Ethical Committee N° 221–018).
Author Contributions
All authors attest that they meet the current International Committee of Medical Journal Editors (ICMJE) criteria for Authorship.
Publication History
Received: 23 April 2021
Accepted: 30 July 2021
Article published online:
16 December 2022
© 2022. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Kramer AH, Zygun DA. Neurocritical care: why does it make a difference?. Curr Opin Crit Care 2014; 20 (02) 174-181
- 2 Jordan CO, Aylward SC. Intracranial hypertension: a current review. Curr Opin Pediatr 2018; 30 (06) 764-774
- 3 Smith M. Refractory Intracranial Hypertension: The Role of Decompressive Craniectomy. Anesth Analg 2017; 125 (06) 1999-2008
- 4 Ohle R, McIsaac SM, Woo MY, Perry JJ. Sonography of the Optic Nerve Sheath Diameter for Detection of Raised Intracranial Pressure Compared to Computed Tomography: A Systematic Review and Meta-analysis. J Ultrasound Med 2015; 34 (07) 1285-1294
- 5 Moretti R, Pizzi B. Ultrasonography of the optic nerve in neurocritically ill patients. Acta Anaesthesiol Scand 2011; 55 (06) 644-652
- 6 del Saz-Saucedo P, Redondo-González O, Mateu-Mateu Á, Huertas-Arroyo R, García-Ruiz R, Botia-Paniagua E. Sonographic assessment of the optic nerve sheath diameter in the diagnosis of idiopathic intracranial hypertension. J Neurol Sci 2016; 361: 122-127
- 7 Amini A, Eghtesadi R, Feizi AM. et al. Sonographic Optic Nerve Sheath Diameter as a Screening Tool for Detection of Elevated Intracranial Pressure. Emergency (Tehran) 2013; 1 (01) 15-19
- 8 Tayal VS, Neulander M, Norton HJ, Foster T, Saunders T, Blaivas M. Emergency department sonographic measurement of optic nerve sheath diameter to detect findings of increased intracranial pressure in adult head injury patients. Ann Emerg Med 2007; 49 (04) 508-514
- 9 Blaivas M, Theodoro D, Sierzenski PR. Elevated intracranial pressure detected by bedside emergency ultrasonography of the optic nerve sheath. Acad Emerg Med 2003; 10 (04) 376-381
- 10 Girisgin AS, Kalkan E, Kocak S, Cander B, Gul M, Semiz M. The role of optic nerve ultrasonography in the diagnosis of elevated intracranial pressure. Emerg Med J 2007; 24 (04) 251-254
- 11 Lee SU, Jeon JP, Lee H. et al. Optic nerve sheath diameter threshold by ocular ultrasonography for detection of increased intracranial pressure in Korean adult patients with brain lesions. Medicine (Baltimore) 2016; 95 (41) e5061
- 12 Sekhon MS, Griesdale DE, Robba C. et al. Optic nerve sheath diameter on computed tomography is correlated with simultaneously measured intracranial pressure in patients with severe traumatic brain injury. Intensive Care Med 2014; 40 (09) 1267-1274
- 13 Raffiz M, Abdullah JM. Optic nerve sheath diameter measurement: a means of detecting raised ICP in adult traumatic and non-traumatic neurosurgical patients. Am J Emerg Med 2017; 35 (01) 150-153
- 14 Jeon JP, Lee SU, Kim SE. et al. Correlation of optic nerve sheath diameter with directly measured intracranial pressure in Korean adults using bedside ultrasonography. PLoS One 2017; 12 (09) e0183170
- 15 Cammarata G, Ristagno G, Cammarata A, Mannanici G, Denaro C, Gullo A. Ocular ultrasound to detect intracranial hypertension in trauma patients. J Trauma 2011; 71 (03) 779-781
- 16 Frumin E, Schlang J, Wiechmann W. et al. Prospective analysis of single operator sonographic optic nerve sheath diameter measurement for diagnosis of elevated intracranial pressure. West J Emerg Med 2014; 15 (02) 217-220
- 17 Dubourg J, Javouhey E, Geeraerts T, Messerer M, Kassai B. Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med 2011; 37 (07) 1059-1068