Optic nerve sheath diameter by ultrasound is a good screening tool for high intracranial pressure in traumatic brain injury

Abstract

Objectives: This study aimed to determine the role of ONSD measurement by US for diagnosis of high ICP in TBI patients. Methods: ONSD measurement by US was performed in adult TBI patients within 1 h of planned CT brain, while CT signs of high ICP were determined. Invasive ICP measurement was performed simultaneously in patients who had intraventricular device in situ. High ICP was determined as ICP > 22 mmHg. Results: A total of 48 patients were enrolled. Twenty-eight patients had positive CT criteria for high ICP, while 20 patients were negative. The mean value of ONSD was 0.63 ± 0.06 cm in positive group compared with 0.55 ± 0.07 cm in negative one with significant difference (p < 0.001). A total of 22 patients had intraventricular device. Thirteen patients had high ICP, while 9 patients had normal ICP. The mean value of ONSD was 0.66 ± 0.05 cm in high ICP group compared with 0.58 ± 0.08 cm in normal one with significant difference (p = 0.004). ONSD with cut-off value > 0.61 cm predicted high ICP with sensitivity of 84.62% and specificity of 66.67% with significant AUC of 0.85 (p = 0.006). Conclusion: ONSD measurement by ultrasound is a good screening tool for high ICP in traumatic brain injury patients.