CNRClinical Neuroscience Research3083-48992981-8133Bio-Byword Scientific Publishing Pty. Ltd.10.26689/cnr.v1i1.4968ArticleEvaluation of Optic Nerve Sheath Diameter Measurement in the Management of Patients Admitted to the Emergency Department with Head Traumahttps://artdesignp.com/journal/CNR/0/0/10.26689/cnr.v1i1.4968CanÖzge,ErselMurat,YalcinliSercan,AkarcaFunda Karbek2024002024-04-16Objective: Ultrasonographic measurements of optic nerve sheath diameter is associated with increased intracranial pressure. Intracranial pressure measurements are usually performed on critical areas or intensive care unit patients. The effect of ultrasonographic measurement of optic nerve sheath diameter in predicting pathology or the need for surgery in mild or moderate head trauma has not been evaluated. In our study, we compared ultrasonographic optic nerve sheath diameter measurements with cranial computed tomography (CT) findings and clinical outcomes of patients with head trauma. Materials and methods: Patients with head trauma admitted to the emergency department who were diagnosed with mild, moderate, and severe brain injury were selected for this retrospective study. The optic nerve sheath diameters were measured by ultrasonography. The findings were compared with the outcome and cranial tomography characteristics of the patients. Results: Of the 58 patients admitted to the emergency department with head trauma, mild traumatic brain injury was most common. Hospitalization or operation was required in 51.7% of the patients (30 patients). The mean optic nerve sheath diameter was 4.96 ± 1.02 mm (3.1–7.3 mm) on the right and 4.92 ± 1.02 mm (3.3–7.8) on the left. Optic nerve sheath diameter of 5 mm or more were statistically significant in predicting hospitalization, the presence of pathology, and increased intracranial pressure on cranial CT (P < 0.05). Conclusion: Optic nerve sheath diameters of patients with moderate and mild head trauma may provide information about the need for hospitalization or surgery and can be used as a triage criterion in determining the need for monitoring and follow-up and imaging priorities.

Moppett IK, 2007, Traumatic Brain Injury: Assessment, Resuscitation and Early Management. Br J Anaesth Br J Anaesth. 99(1): 18–31. https://www.doi.org/10.1093/bja/aem128

Helmy A, Vizcaychipi M, Gupta AK, 2007, Traumatic Brain Injury: Intensive Care Management. Br J Anaesth, 99(1): 32–42. https://www.doi.org/10.1093/bja/aem139

Jimenez Restrepo JN, León OJ, Quevedo Florez LA, 2019, Ocular Ultrasonography: A Useful Instrument in Patients with Trauma Brain Injury in Emergency Service. Emerg Med Int., 2019: 9215853. https://www.doi.org/10.1155/2019/9215853

Rosenfeld JV, Maas AI, Bragge P, et al., 2012, Early Management of Severe Traumatic Brain Injury. Lancet, 380(9847):1088–1098. https://www.doi.org/10.1016/S0140-6736(12)60864-2

Martin M, Lobo D, Bitot V, et al., 2019, Prediction of Early Intracranial Hypertension After Severe Traumatic Brain Injury: A Prospective Study. World Neurosurg, 127: e1242–e1248. https://www.doi.org/10.1016/j.wneu.2019.04.121

Geeraerts T, Launey Y, Martin L, et al., 2007, Ultrasonography of the Optic Nerve Sheath May be Useful for Detecting Raised Intracranial Pressure After Severe Brain Injury. Intensive Care Med., 33(10): 1704–1711. https://www.doi.org/10.1007/ s00134-007-0797-6

Blaivas M, Theodoro D, Sierzenski PR, 2003, Elevated Intracranial Pressure Detected by Bedside Emergency Ultrasonography of the Optic Nerve Sheath. Acad Emerg Med. 10(4): 376–381. https://www.doi.org/10.1197/aemj.10.4.376

Tayal VS, Neulander M, Norton HJ, et al., 2007, Emergency Department Sonographic Measurement of Optic Nerve Sheath Diameter to Detect Findings of Increased Intracranial Pressure in Adult Head Injury Patients. Ann Emerg Med, 49(4): 508–514. https://www.doi.org/10.1016/j.annemergmed.2006.06.040

Seabury SA, Gaudette É, Goldman DP, et al., 2018, Assessment of Follow-up Care After Emergency Department Presentation for Mild Traumatic Brain Injury and Concussion: Results From the TRACK-TBI Study. JAMA Netw Open, 1(1): e180210. https://www.doi.org/10.1001/jamanetworkopen.2018.0210

Altayar AS, Abouelela AZ, Abdelshafey EE, et al., 2021, Optic Nerve Sheath Diameter by Ultrasound is a Good Screening Tool for High Intracranial Pressure in Traumatic Brain Injury. Ir J Med Sci., 190(1): 387–393. https://www.doi.org/10.1007/s11845-020-02242-2

Robba C, Santori G, Czosnyka M, et al., 2018, Optic Nerve Sheath Diameter Measured Sonographically as Noninvasive Estimator of Intracranial Pressure: A Systematic Review and Meta-Analysis. Intensive Care Med., 44(8): 1284–1294. https://www.doi.org/10.1007/s00134-018-5305-7

Soldatos T, Chatzimichail K, Papathanasiou M, et al., 2009, Optic Nerve Sonography: A New Window for the Non-Invasive Evaluation of Intracranial Pressure in Brain Injury. Emerg Med J., 26(9): 630–634. https://www.doi.org/10.1136/emj.2008.058453

Amini A, Kariman H, Arhami Dolatabadi A, et al., 2013, Use of the Sonographic Diameter of Optic Nerve Sheath to Estimate Intracranial Pressure. Am J Emerg Med., 31(1): 236–239. https://www.doi.org/10.1016/j.ajem.2012.06.025

Major R, Girling S, Boyle A, 2011, Ultrasound Measurement of Optic Nerve Sheath Diameter in Patients with a Clinical Suspicion of Raised Intracranial Pressure. Emerg Med J., 28(8): 679–681. https://www.doi.org/10.1136/emj.2009.087353

Roque PJ, Wu TS, Barth L, et al., 2012, Optic Nerve Ultrasound for the Detection of Elevated Intracranial Pressure in the Hypertensive Patient. Am J Emerg Med., 30(8): 1357–1363. https://www.doi.org/10.1016/j.ajem.2011.09.025

Das SK, Shetty SP, Sen KK, 2017, A novel triage tool: Optic Nerve Sheath Diameter in Traumatic Brain Injury and its Correlation to Rotterdam Computed Tomography (CT) scoring. Polish J Radiol., 82: 240–243. https://www.doi.org/10.12659/PJR.900196

Raffiz M, Abdullah JM, 2017, Optic Nerve Sheath Diameter Measurement: A Means of Detecting Raised ICP in Adult Traumatic and Non-Traumatic Neurosurgical Patients. Am J Emerg Med, 35(1): 150–153. https://www.doi.org/10.1016/j.ajem.2016.09.044

Jeon JP, Lee SU, Kim SE, et al., 2017, Correlation of Optic Nerve Sheath Diameter with Directly Measured Intracranial Pressure in Korean Adults using Bedside Ultrasonography. PLoS One., 12(9): 1–11. https://www.doi.org/10.1371/journal.pone.0183170