scholarly journals Diagnostic and clinical predictive value of optic nerve sheath diameter measurement in children with increased intracranial pressure

2021 ◽  
Author(s):  
Özlem Tolu Kendir
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Predictive Value ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Diameter Measurement ◽  
Increased Intracranial Pressure ◽  
Nerve Sheath

scholarly journals Optic Nerve Sheath Diameter Cutoff Point for Detection of Increased Intracranial Pressure in the Emergency Department

2020 ◽  
Vol 8 (B) ◽  
pp. 62-65
Author(s):  
Wanatchaporn Ussahgij ◽  
Wipada Toonpirom ◽  
Waranon Munkong ◽  
Kamonwon Lenghong ◽  
Korakot Apiratwarakul
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Ct Scan ◽  
Predictive Value ◽  
Optic Nerve Sheath Diameter ◽  
Cutoff Point ◽  
Optic Nerve Sheath ◽  
Increased Intracranial Pressure ◽  
Noninvasive Methods ◽  
Nerve Sheath

BACKGROUND: Ultrasound of the optic nerve sheath diameter (ONSD) is one of the most widely used noninvasive methods of screening for high intracranial pressure. AIM: This study aimed to measure the ONSD and to find the appropriate cutoff point to indicate increased intracranial pressure. METHODS: We examined 93 participants over 18 years of age with abnormal neurologic signs or symptoms and took computerized tomography (CT) scans of their brains. We measured the ONSD through ultrasound with the head positioned at 30°. We also used a linear array probe to measure the ONSD in the position after connecting the eyeball 3 mm. RESULTS: The average of the ONSD at each side was 4.76 mm (95% confidence interval [CI]: 4.65–4.87) in the normal CT scan group and 5.33 mm (95% CI: 5.13–5.33) in the abnormal CT scan (indicating high intracranial pressure) group. An ONSD cutoff point of 5.0 mm yielded 74.14% sensitivity and 49.22% specificity. The positive predictive value was 0.38 and negative predictive value was 0.82. CONCLUSION: The ONSD in the abnormal CT scan group was greater than in the normal CT scan group, and an ONSD of 5.0 mm can be used as a cutoff point for detecting increased intracranial pressure.

Ultrasonographic optic nerve sheath diameter to detect increased intracranial pressure in adults: a meta-analysis

2018 ◽  
Vol 60 (2) ◽  
pp. 221-229 ◽  
Author(s):  
Sung-Eun Kim ◽  
Eun Pyo Hong ◽  
Heung Cheol Kim ◽  
Si Un Lee ◽  
Jin Pyeong Jeon
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Meta Analysis ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Increased Intracranial Pressure ◽  
Summary Receiver Operating Characteristic ◽  
Nerve Sheath ◽  
Study Characteristics ◽  
Meta Regression

Background The optimal optic nerve sheath diameter (ONSD) cut-off for identifying increased intracranial pressure (IICP) remains unclear in adult patients. Purpose To validate the diagnostic accuracy of ultrasonographic (US) ONSD > 5.0 mm as a cut-off for detecting IICP by computed tomographic (CT) through a meta-analysis. Material and Methods A systemic literature review was performed of online databases from January 1990 to September 2017. A bivariate random-effects model was used to estimate pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence intervals (CIs). A summary receiver operating characteristic (SROC) graph was used to provide summary points for sensitivity and specificity. Meta-regression tests were performed to estimate the influence of the study characteristics on DOR. Publication bias was assessed using Deeks' funnel plot asymmetry test. Results Six studies with 352 patients were included in the meta-analysis. US ONSD > 5.0 mm revealed pooled sensitivity of 99% (95% CI = 96–100) and specificity of 73% (95% CI = 65–80) for IICP detection. DOR was 178. The area under the SROC curve was 0.981, indicating a good level of accuracy. Meta-regression studies showed no significant associations between DOR and study characteristics such as probe mode (relative DOR [RDOR] = 0.60; P = 0.78), study quality (RDOR = 0.52; P = 0.67), IICP prevalence (RDOR = 0.04; P = 0.17), or pathology at admission (RDOR = 1.30; P = 0.87). Conclusion US ONSD > 5.0 mm can be used to rapidly detect IICP in adults in emergency departments and intensive care units. Further meta-analysis based on individual patient-level databases is needed to confirm these results.

scholarly journals Accuracy of Noninvasive Intraocular Pressure or Optic Nerve Sheath Diameter Measurements for Predicting Elevated Intracranial Pressure in Cryptococcal Meningitis

2014 ◽  
Vol 1 (3) ◽  
Author(s):  
Henry W. Nabeta ◽  
Nathan C. Bahr ◽  
Joshua Rhein ◽  
Nicholas Fossland ◽  
Agnes N. Kiragga ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Cryptococcal Meningitis ◽  
Optic Nerve Sheath Diameter ◽  
Diagnostic Value ◽  
Optic Nerve Sheath ◽  
Increased Intracranial Pressure ◽  
Nerve Sheath ◽  
Immunodeficiency Virus

Abstract Background.  Cryptococcal meningitis is associated with increased intracranial pressure (ICP). Therapeutic lumbar puncture (LP) is recommended when the initial ICP is >250 mm H2O, yet the availability of manometers in Africa is limited and not always used where available. We assessed whether intraocular pressure could be a noninvasive surrogate predictor to determine when additional therapeutic LPs are necessary. Methods.  Ninety-eight human immunodeficiency virus-infected Ugandans with suspected meningitis (81% Cryptococcus) had intraocular pressure measured using a handheld tonometer (n = 78) or optic nerve sheath diameter (ONSD) measured by ultrasound (n = 81). We determined the diagnostic performance of these methods for predicting ICP vs a standard manometer. Results.  The median ICP was 225 mm H2O (interquartile range [IQR], 135–405 mm H2O). The median intraocular pressure was 28 mm Hg (IQR, 22–37 mm Hg), and median ultrasound ONSD was 5.4 mm (IQR, 4.95–6.1 mm). ICP moderately correlated with intraocular pressure (ρ = 0.45, P < .001) and with ultrasound ONSD (ρ = 0.44, P < .001). There were not discrete threshold cutoff values for either tonometry or ultrasound ONSD that provided a suitable cutoff diagnostic value to predict elevated ICP (>200 mm H2O). However, risk of elevated ICP >200 mm H2O was increased with an average intraocular pressure >28 mm Hg (relative risk [RR] = 3.03; 95% confidence interval [CI], 1.55–5.92; P < .001) or an average of ONSD >5 mm (RR = 2.39; 95% CI, 1.42–4.03; P = .003). As either intraocular pressure or ONSD increased, probability of elevated ICP increased (ie, positive predictive value increased). Conclusions.  Noninvasive intraocular pressure measurements by tonometry or ultrasound correlate with cerebrospinal fluid opening pressure, but both are a suboptimal replacement for actual ICP measurement with a manometer.

scholarly journals How accurate is ultrasound of the optic nerve sheath diameter performed by inexperienced operators to exclude raised intracranial pressure?

2015 ◽  
Vol 19 (1) ◽  
Author(s):  
G. J. Du Toit ◽  
D. Hurter ◽  
M. Nel
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Lumbar Puncture ◽  
Predictive Value ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Ultrasound Measurement ◽  
Raised Intracranial Pressure ◽  
Cross Sectional ◽  
Nerve Sheath

Background: It has been well documented that ultrasound measurement of the optic nerve sheath diameter performed by an experienced operator shows good correlation with raised intracranial pressure, irrespective of the cause. Objective: To establish the accuracy of this technique performed by inexperienced operators.Method: A prospective analytical cross-sectional study was conducted. All patients ≥18 years of age who presented at our medical casualty and emergency departments with suspected meningitis were enrolled in the study. All patients were evaluated with the use of optic nerve sheath diameter ultrasound with or without computed tomography brain scan prior to lumbar puncture. Lumbar puncture opening pressure measurements were compared with the ultrasound measurements.Results: A total of 73 patients were enrolled in the study, of whom 14 had raised intracranial pressure. The study had a sensitivity of 50% (95% confidence interval (CI) 26.8%–73.2%) and specificity of 89.8% (95% CI 79.5%–95.3%) with a positive predictive value of 54.8% (95% CI 29.1%–76.8%) and negative predictive value of 88.3% (95% CI 77.8%–94.2%). The likelihood ratio of a positive test was 4.92 (95% CI 1.95–11.89) and that of a negative test 0.56 (95% CI 0.29–0.83). Cohen’s kappa value was 0.41 which indicates a moderate agreement. The receiver operating characteristic (ROC) curve had an area under the curve (AUC) of 0.73 (95% CI 0.51–0.95). Conclusion: Ultrasound measurement of the optic nerve sheath diameter can be used to exclude raised intracranial pressure, even in the hands of inexperienced operators.

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