Published online Jan 9, 2023. doi: 10.5492/wjccm.v12.i1.10
Peer-review started: November 4, 2022
First decision: November 30, 2022
Revised: December 5, 2022
Accepted: December 23, 2022
Article in press: December 23, 2022
Published online: January 9, 2023
Processing time: 60 Days and 2.9 Hours
Delay in treatment of raised intracranial pressure (ICP) leads to poor clinical outcomes. Optic nerve sheath diameter (ONSD) by ultrasonography (US-ONSD) has shown good accuracy in traumatic brain injury and neurosurgical patients to diagnose raised ICP. However, there is a dearth of data in neuro-medical in
To validate the diagnostic accuracy of ONSD in non-traumatic neuro-critically ill patients.
We prospectively enrolled 114 patients who had clinically suspected raised ICP due to non-traumatic causes admitted in neuro-medical ICU. US-ONSD was performed according to ALARA principles. A cut-off more than 5.7 mm was taken as significantly raised. Raised ONSD was corelated with raised ICP on radi
There was significant association between raised ONSD and raised ICP on im
ONSD can be used as a screening a test to detect raised ICP in a medical ICU and as a trigger to initiate further management of raised ICP. ONSD can be beneficial in ruling out a diagnosis in a low-prevalence population and rule in a diagnosis in a high-prevalence population.
Core Tip: Raised intracranial pressure (ICP) maybe present in a significant proportion of neuro-critically ill patients and any delay in its management may lead to poor outcomes. Even though the gold standard for measuring raised ICP is the intraventricular catheter, it is invasive, not widely available, requires expertise in insertion and maintenance and may be associated with many risks. Hence, non-invasive methods like computed tomography scan or magnetic resonance imaging are being increasingly used to diagnose raised ICP. However, their utility is also restricted by logistical issues and have limited repeatability. Bedside ultrasonography measuring optic nerve sheath diameter (ONSD) can be used as a screening test to detect raised ICP and as a trigger to initiate further management. ONSD can also be beneficial in ruling out a diagnosis in a low-prevalence population and rule in a diagnosis in a high-prevalence population.