Relationship of optic nerve sheath diameter and intracranial hypertension in patients with traumatic brain injury

Ammar Al-Hassani, Gustav Strandvik, Sheraz Abayazeed, Khalid Ahmed, Ayman El-Menyar, Ismail Mahmood, Suresh Kumar Arumugam, Mohammad Asim, Syed Nabir, Nadeem Ahmed, Zahoor Ahmed, Hassan Al-Thani

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background: to study the association between optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in patients with moderate-to-severe brain injury. Patients and Methods: A retrospective cohort study of traumatic brain injury (TBI) patients was conducted between 2010 and 2014. Data were analyzed and compared according to the ICP monitoring cutoff values. Outcomes included intracranial hypertension (ICH) and mortality. Results: A total of 167 patients with a mean age of 33 ± 14 years, of them 96 had ICP monitored. ICP values correlated with ONSD measurement (r = 0.21, P = 0.04). Patients who developed ICH were more likely to have higher mean ONSD (P = 0.01) and subarachnoid hemorrhage (SAH) (P = 0.004). Receiver operating curve for ONSD showed a cutoff value of 5.6 mm to detect ICH with sensitivity 72.2% and specificity 50%. Age and ICP were independent predictors of inhospital mortality in multivariate model. Another model with same covariates showed ONSD and SAH to be independent predictors of ICH. Simple linear regression showed a significant association of ONSD with increased ICP (β = 0.21, 95% confidence interval 0.25-5.08, P = 0.03). Conclusions: ONSD is a simple noninvasive measurement on initial CT in patients with TBI that could be a surrogate for ICP monitoring. However, further studies are warranted.

Original languageEnglish
Pages (from-to)183-189
Number of pages7
JournalJournal of Emergencies, Trauma and Shock
Volume13
Issue number3
DOIs
Publication statusPublished - 1 Jul 2020
Externally publishedYes

Keywords

  • Computed tomography
  • intracranial pressure
  • optic nerve sheath diameter
  • traumatic brain injury

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