Transorbital Ultrasonographic Measurement of Optic Nerve Sheath Diameter for Intracranial Midline Shift in Patients with Head Trauma

World Neurosurg. 2016 Jan:85:292-7. doi: 10.1016/j.wneu.2015.10.015. Epub 2015 Oct 17.

Abstract

Objective: Measurement of the optic nerve sheath diameter (ONSD) by using sonography is a straightforward, noninvasive technique to detect an increased intracranial pressure, which can even be conducted at the bedside. However, the correlation between ONSD and intracranial midline shift has not been studied.

Methods: The authors performed a prospective, blinded observational study in an intensive care unit. Forty-five patients were divided into groups. Of those, 19 patients had a midline shift, whereas 26 had no intracranial pathology or shift and served as control individuals.

Results: Spearman rank correlation coefficient of difference of ONSD and midline shift was 0.761 (P < 0.0005), demonstrating a significant positive correlation between patients with midline shift and control group.

Conclusions: Despite small numbers and selection bias, this study suggests that bedside ultrasound may be useful in the diagnosis of midline intracranial shift by measurement of ONSD.

Keywords: Intensive care unit; Intracranial midline shift; Optic nerve sheath diameter; Transorbital ultrasound.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Edema / diagnostic imaging
  • Craniocerebral Trauma / diagnostic imaging*
  • Echoencephalography / methods*
  • Female
  • Humans
  • Intensive Care Units
  • Intracranial Hemorrhage, Traumatic / diagnostic imaging
  • Intracranial Hypertension / diagnostic imaging*
  • Male
  • Middle Aged
  • Myelin Sheath / diagnostic imaging*
  • Optic Nerve / diagnostic imaging*
  • Point-of-Care Testing*
  • Prospective Studies
  • Reference Values
  • Sensitivity and Specificity