Optic nerve sheath diameter and eyeball transverse diameter in severe head injury and its correlation with intracranial pressure.
Clin Neurol Neurosurg
; 242: 108310, 2024 07.
Article
in En
| MEDLINE
| ID: mdl-38788542
ABSTRACT
BACKGROUND:
Gold standard for determining intracranial pressure (ICP), intraventricular catheter, is invasive with associated risks. Non-invasive investigations like magnetic resonance imaging and ultrasonography have demonstrated correlation between optic nerve sheath diameter (ONSD) and raised ICP. However, computed tomography (CT) is accessible and less operator-dependent. Literature shows variable results regarding correlations between ICP and ONSD on CT. The study aimed to investigate correlations between raised ICP and ONSD, eyeball transverse diameter (ETD), and ONSD/ETD ratios on CT scan(s) of severe head injuries.METHODS:
A retrospective review of a three-year prospectively-maintained database of severe traumatic head injuries in patients who had ICP measurements and CT scans was conducted. Glasgow Coma Score (GCS), ICP, ONSD 3â¯mm and 9â¯mm behind the globe, ETD, ONSD/ETD ratios, CT Marshall Grade, and Glasgow Outcome Score (GOS) were recorded. Statistical analysis assessed correlations between ICP and CT measurements.RESULTS:
Seventy-four patients were assessed; mortality rate 36.5â¯%. Assault (48.6â¯%) and pedestrian-vehicle collisions (21.6â¯%) were the most common mechanisms. CT Marshall Grade correlated significantly with 3â¯mm and 9â¯mm ONSD, ONSD/ETD ratios, GCS, and GCS motor score, which correlated significantly with GOS. No significant correlation was found between ICP and ONSD, ETD or ONSD/ETD ratios. Marshall Grade was not significantly associated with ICP measurements but correlated with injury severity.CONCLUSIONS:
Unlike previous studies, our study not only investigated the correlation between ICP and single variables (ONSD and ETD) but also the ONSD/ETD ratios. No correlations were observed between raised ICP and ONSD, ETD or ONSD/ETD ratio on CT in neurotrauma patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Optic Nerve
/
Intracranial Pressure
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Tomography, X-Ray Computed
/
Craniocerebral Trauma
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Clin Neurol Neurosurg
Year:
2024
Document type:
Article