The Relationship Between USG-Based Optic Nerve Sheath Diameter and Manifestations of Increased Intracranial Pressure in Patients with Non-Traumatic Intracranial Lesions in Dr. Soetomo Surabaya Hospital
DOI:
https://doi.org/10.52783/jns.v14.2193Keywords:
ONSD, space occupying lesion, stroke, CNS infections, intracranial pressure, ultrasonographyAbstract
The incidence of non-traumatic increased intracranial pressure (ICP) associated with intracranial lesions is increasing. These patients exhibit increased morbidity and mortality rates. Immediate identification and timely intervention can reduce the death rate by around 50%. The Optic Nerve Sheath Diameter (ONSD) measurement is a recently developed non-invasive method for measuring intracranial pressure (ICP). It has been shown to be a dependable method. The purpose of this study was to analyze the relationship between ONSD measured by ultrasonography and clinical manifestations such as headache, projectile vomiting, seizures, decreased consciousness, Cushing’s triad, and pupillary diameter in patients with non-traumatic intracranial lesions at Dr. Soetomo Hospital Surabaya. This study is a cross sectional conducted in the emergency room of RSUD Dr. Soetomo from February to April 2023. Patients aged 18-60 with non-traumatic intracranial lesions who underwent a CT scan were selected using consecutive sampling. The optic nerve sheath diameter (ONSD) was evaluated using an ultrasonography in both eyes. The contigency coefficient test was used to determine the association between ONSD and clinical manifestations. The study included 41 subjects, with an average age of 45.66 years. The ONSD diameter was higher than the cut-off point (≥ 5.70 mm) in patients with space occupying lesions, strokes, and central nervous system infections (60%, 47.8%, and 37.5%, respectively). We found a statistically significant association between ONSD of the right and left eye and headache (p<0.05), seizures (p<0.05), Cushing’s triad (p<0.05), and pupillary diameter (p<0.05). In conclusion, there is a significant association between ONSD and clinical manifestations of increased intracranial pressure including headache, seizure, decreased consciousness, Cushing’s triad, and pupillary diameter.
Downloads
Metrics
References
Rangel-Castilla L, Gasco J, Nauta HJW, Okonkwo DO, Robertson CS. Cerebral pressure autoregulation in traumatic brain injury. Neurosurg Focus. 2008;25(4):E7.
Rigi M, Almarzouqi SJ, Morgan ML, Lee AG. Papilledema: epidemiology, etiology, and clinical management. Eye Brain. 2015;7:47–57.
Rudiharto T, Murtala B, Asriyani S, Muis M, Kaelan C, Bahar B. Hubungan antara Diameter Optic Nerve Sheath pada Grey Scale Ultrasound dengan Peningkatan Tekanan Intrakranial pada Pasien dengan Lesi Intrakranial. Majalah Sainstekes. 2019;6(1).
Yogipranata RM, Sukmani H. Korelasi Diameter Selubung Nervus Optik dan Marshall CT Score dengan Skala Koma Glasgow pada Cedera Kepala. Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia. 2018;35(3).
Dubourg J, Javouhey E, Geeraerts T, Messerer M, Kassai B. Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med. 2011;37(7):1059–68.
Bhide M, Singh O, Juneja D, Goel A. Bedside ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure in nontraumatic neuro-critically ill patients. World J Crit Care Med. 2023;12(1):10–7.
Aduayi OS, Asaleye CM, Adetiloye VA, Komolafe EO, Aduayi VA. Optic nerve sonography: A noninvasive means of detecting raised intracranial pressure in a resource-limited setting. J Neurosci Rural Pract. 2015;6(4):563–7.
Ali MA, Hashmi M, Shamim S, Salam B, Siraj S, Salim B. Correlation of Optic Nerve Sheath Diameter with Direct Measurement of Intracranial Pressure through an External Ventricular Drain. Cureus. 2019;11(9):e5777.
9. Du Toit GJ, Hurter D, Nel M. How accurate is ultrasound of the optic nerve sheath diameter performed by inexperienced operators to exclude raised intracranial pressure? South African Journal of Radiology. 2015;19(1):5.
Montorfano L, Yu Q, Bordes SJ, Sivanushanthan S, Rosenthal RJ, Montorfano M. Mean value of B-mode optic nerve sheath diameter as an indicator of increased intracranial pressure: a systematic review and meta-analysis. Ultrasound J. 2021;13(1):35.
Munawar K, Khan MT, Hussain SW, Qadeer A, Shad ZS, Bano S, et al. Optic Nerve Sheath Diameter Correlation with Elevated Intracranial Pressure Determined via Ultrasound. Cureus. 2019;11(2):e4145.
Nabeta HW, Bahr NC, Rhein J, Fossland N, Kiragga AN, Meya DB, et al. Accuracy of noninvasive intraocular pressure or optic nerve sheath diameter measurements for predicting elevated intracranial pressure in cryptococcal meningitis. Open Forum Infect Dis. 2014;1(3):ofu093.
Sharma S, Hashmi MF, Kumar A. Intracranial Hypertension. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
Jang SH, Kim OL, Kim SH, Kim JB. The Relation Between Loss of Consciousness, Severity of Traumatic Brain Injury, and Injury of Ascending Reticular Activating System in Patients With Traumatic Brain Injury. Am J Phys Med Rehabil. 2019;98(12):1067–71.
Allan JS. Diagnostic Utility and Accuracy of Optic Nerve Sheath Diameter (ONSD) in detecting raised Intracranial Tension [Internet] [masters]. Christian Medical College, Vellore; 2016. Available from: Available at: http://repository-tnmgrmu.ac.in/id/eprint/10485.
Sulistyani S, Danuaji R. Perbedaan Optic Nerve Sheath Diameter (ONSD) pada Responden Normal dan Nyeri Kepala. Biomedika. 2019;11(2):96–104.
Karadag MK, Akyuz ME, Sahin MH. The role of ONSD in the assessment of headache associated with Chiari malformation type 1. Front Neurol. 2023;14:1127279.
Lee SU, Jeon JP, Lee H, Han JH, Seo M, Byoun HS, et al. Optic nerve sheath diameter threshold by ocular ultrasonography for detection of increased intracranial pressure in Korean adult patients with brain lesions. Medicine (Baltimore). 2016;95(41):e5061.
Datta P, Sutradhar S, Khan M, Hossain M, Mahamud Sumon S, Hasan I, et al. Clinical Pattern of Intra-cranial space occupying lesion in Tertiary Level Hospital. Journal of Dhaka Medical College. 2020 Mar 3;28:17–22.
Çolak T, Tekten B, Celik K. Prognostic value of the optic nerve sheath thickness as an indicator of intracranial pressure among acute stroke patients. Experimental Biomedical Research. 2020;3:157–66.
Komut E, Kozacı N, Sönmez BM, Yılmaz F, Komut S, Yıldırım ZN, et al. Bedside sonographic measurement of optic nerve sheath diameter as a predictor of intracranial pressure in ED. Am J Emerg Med. 2016;34(6):963–7.
Sadoughi A, Rybinnik I, Cohen R. Measurement and Management of Increased Intracranial Pressure. The Open Critical Care Medicine Journal. 2013;6(1):56–65.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
