Intracranial Pressure Assessment in Traumatic Head Injury with Hemorrhage Via Optic Nerve Sheath Diameter
| Autor: | Inessa Bekerman, Tal Sigal, Michael Vaiman, Itzhak Kimiagar |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Optic nerve sheath Intracranial Pressure Computed tomography Young Adult 03 medical and health sciences 0302 clinical medicine Hematoma Brain Injuries Traumatic Traumatic head injury medicine Humans Inverse correlation Cerebral Hemorrhage Retrospective Studies Intracranial pressure medicine.diagnostic_test business.industry Glasgow Coma Scale Optic Nerve 030208 emergency & critical care medicine medicine.disease Surgery Optic nerve Female Neurology (clinical) Tomography X-Ray Computed Nuclear medicine business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurotrauma. 33:2147-2153 |
| ISSN: | 1557-9042 0897-7151 |
| Popis: | Our purpose was to improve the technique of measuring optic nerve sheath diameter (ONSD) for intracranial pressure (ICP) monitoring in cases of traumatic head injury with hemorrhage. In a retrospective study, computed tomography (CT) data of 312 adult patients were collected and analyzed. ONSDs were measured at 3 mm and 8-10 mm distance from the globe together with the eyeball transverse diameter (ETD). The ONSD/ETD ratio was calculated. The correlation analysis was performed with gender, age, Glasgow Coma Scale score, and Glasgow Outcome Score. ONSD was enlarged in all cases when CT scans indicated hematoma. Enlarged right/left ONSDs were 6.5 ± 1.5/6.4 ± 1.3 mm at 3 mm and 6.6 ± 0.8/6.6 ± 0.6 mm at 8-10 mm from the globe (cut-off value5.5 mm). ONSD/ETD ratio was 0.29 ± 0.05, compared with 0.19 ± 0.02 in healthy adults (p 0.01). We did not find a correlation between ONSD/ETD ratio and initial Glasgow Coma Scale score, but there was an inverse correlation between ONSD/ETD ratio and Glasgow Outcome Score (r = -0.83). We conclude that in cases with a traumatic head injury with hemorrhage, the ONSD is significantly enlarged, indicating elevated ICP. In ICP assessment, the most accurate results can be obtained if the ONSD is measured 8-10 mm from the globe and the ONSD/ETD ratio is calculated. |
| Databáze: | OpenAIRE |
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