Relationship of the optic nerve sheath diameter and repeated invasive intracranial pressure measures in traumatic brain injury patients; a diagnostic accuracy study

Abstract

Objective: The purpose of this study was to quantitatively evaluate if the use of the optic nerve sheath diameter (ONSD) can be a suitable noninvasive surrogate approach for repeated invasive intracranial pressure (ICP) measures. Methods: The study used a sample of 22 adult patients with traumatic brain injury (TBI) from an in intensive care unit (ICU). ICP levels were measured using the gold standard and recorded in cmH20. ONSD was measured using ultrasonography with 5.6-5.7 MHz linear probe and recorded in millimeters. The data analysis was done using STATA software version 15. Results: The results showed a strong positive correlation between ICP and ONSD (r = 0.743, p = 0.001). The accuracy of the sonographic ONSD declined over time, starting from a high of 90.9% at the baseline and declining to a low of merely 20.0% after 48 hours. Conclusion: These findings indicate that the ONSD approach could be very useful alternative and noninvasive method for monitoring ICP.   

1. Noble KA. Traumatic brain injury and increased intracranial pressure. J Perianesth Nurs. 2010;25(4):242-8.
2. Heydari F, Golban M, Majidinejad S. Traumatic brain injury in older adults presenting to the emergency department: epidemiology, outcomes and risk factors predicting the prognosis. Adv J Emerg Med. 2020;4(2):e19.
3. Nag DS, Sahu S, Swain A, Kant S. Intracranial pressure monitoring: Gold standard and recent innovations. World J Clin Cases. 2019;7(13):1535-53.
4. Ganslandt O, Mourtzoukos S, Stadlbauer A, Sommer B, Rammensee R. Evaluation of a novel noninvasive ICP monitoring device in patients undergoing invasive ICP monitoring: preliminary results. J Neurosurg. 2017;128(6):1653-60.
5. Khan MN, Shallwani H, Khan MU, Shamim MS. Noninvasive monitoring intracranial pressure–a review of available modalities. Surg Neurol Int. 2017;8:51.
6. Zhang X, Medow JE, Iskandar BJ, Wang F, Shokoueinejad M, Koueik J, et al. Invasive and noninvasive means of measuring intracranial pressure: a review. Physiol Meas. 2017;38(8):R143-82.
7. Allen A, Grigorian A, Christian A, Schubl SD, Barrios Jr C, Lekawa M, et al. Intracranial pressure monitors associated with increased venous thromboembolism in severe traumatic brain injury. Eur J Trauma Emerg Surg. 2021;47(5):1483-90.
8. 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(1):150-3.
9. Robba C, Santori G, Czosnyka M, Corradi F, Bragazzi N, Padayachy L, et al. Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: a systematic review and meta-analysis. Intensive Care Med. 2018;44(8):1284-94.
10. Canac N, Jalaleddini K, Thorpe SG, Thibeault CM, Hamilton RB. pathophysiology of intracranial hypertension and noninvasive intracranial pressure monitoring. Fluids Barriers CNS. 2020;17:40.
11. Soldatos T, Chatzimichail K, Papathanasiou M, Gouliamos A. Optic nerve sonography: a new window for the non-invasive evaluation of intracranial pressure in brain injury. Emerg Med J. 2009;26(9):630-4.
12. Komut E, Kozacı N, Sönmez BM, Yılmaz F, Komut S, Yıldırım ZN, et al. Bedside sonographic measurement of optic nerve sheath diameter as a predictor of intracranial pressure in ED. Am J Emerg Med. 2016;34(6):963-7.
13. Houzé-Cerfon C-H, Bounes V, Guemon J, Le Gourrierec T, Geeraerts T. Quality and feasibility of sonographic measurement of the optic nerve sheath diameter to estimate the risk of raised intracranial pressure after traumatic brain injury in prehospital setting. Prehosp Emerg Care. 2019;23(2):277-83.
14. Abdolrazaghnejad A, Banaie M, Safdari M. Ultrasonography in emergency department; a diagnostic tool for better examination and decision-making. Adv J Emerg Med. 2018;2(1):e7.
15. Evensen KB, Eide PK. Measuring intracranial pressure by invasive, less invasive or non-invasive means: limitations and avenues for improvement. Fluids Barriers CNS. 2020;17(1):34.
16. 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(7):1285-94.
17. Maissan IM, Dirven PJ, Haitsma IK, Hoeks SE, Gommers D, Stolker RJ. Ultrasonographic measured optic nerve sheath diameter as an accurate and quick monitor for changes in intracranial pressure. J Neurosurg. 2015;123(3):743-7.
18. Kalantari H, Jaiswal R, Bruck I, Matari H, Ghobadi F, Weedon J, et al. Correlation of optic nerve sheath diameter measurements by computed tomography and magnetic resonance imaging. Am J Emerg Med. 2013;31(11):1595-7.
19. Ogle KY, Lewiss RE. Optic Nerve Sheath Ultrasonography: Should We Be Using It for Bedside Diagnosis of Increased Intracranial Pressure? Ann Intern Med. 2019;171(12):935-6.
20. Koziarz A, Sne N, Kegel F, Nath S, Badhiwala JH, Nassiri F, et al. Bedside optic nerve ultrasonography for diagnosing increased intracranial pressure: a systematic review and meta-analysis. Ann Intern Med. 2019;171(12):896-905.
Files
IssueVol 6 No 1 (2022): Winter (February) QRcode
SectionOriginal article
DOI 10.18502/fem.v6i1.7678
Keywords
Intracranial Pressure Optic Nerve Point-of-Care Systems ultrasonography

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Mehrpour S, Najafi A, Ahmadi A, Zarei T, Pleqi V, Basiri K, Komlakh K, Abdollahi H, Hedayati Emami K. Relationship of the optic nerve sheath diameter and repeated invasive intracranial pressure measures in traumatic brain injury patients; a diagnostic accuracy study. Front Emerg Med. 2021;6(1):e6.

Downloads

Download data is not yet available.

Most read articles by the same author(s)