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PLoS One. 2017 Sep 13;12(9):e0183170. doi: 10.1371/journal.pone.0183170. eCollection 2017.

Correlation of optic nerve sheath diameter with directly measured intracranial pressure in Korean adults using bedside ultrasonography.

Author information

1
Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Korea.
2
New Frontier Research Institute, Hallym University College of Medicine, Chuncheon, Korea.
3
Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
4
Department of Emergency Medicine, Seoul Emergency Operations Center, Seoul, Korea.
5
Department of Anesthesiology and Pain Medicine, Veterans Health Service Medical Center, Seoul, Korea.

Abstract

OBJECTIVES:

The correlation of optic nerve sheath diameter (ONSD) as seen on ultrasonography (US) and directly measured intracranial pressure (ICP) has been well described. Nevertheless, differences in ethnicity and type of ICP monitor used are obstacles to the interpretation. Therefore, we investigated the direct correlation between ONSD and ventricular ICP and defined an optimal cut-off point for identifying increased ICP (IICP) in Korean adults with brain lesions.

METHODS:

This prospective study included patients who required an external ventricular drainage (EVD) catheter for ICP control. IICP was defined as an opening pressure over 20 mmHg. ONSD was measured using a 13 MHz US probe before the procedure. Linear regression analysis and receiver operator characteristic (ROC) curve were used to assess the association between ONSD and ICP. Optimal cut-off value for identifying IICP was defined.

RESULTS:

A total of 62 patients who underwent ONSD measurement with simultaneous EVD catheter placement were enrolled in this study. Thirty-two patients (51.6%) were found to have IICP. ONSD in patients with IICP (5.80 ± 0.45 mm) was significantly higher than in those without IICP (5.30 ± 0.61 mm) (P < 0.01). The IICP group showed more significant linear correlation with ONSD (r = 0.57, P < 0.01) compared to the non-IICP group (r = 0.42, P = 0.02). ONSD > 5.6 mm disclosed a sensitivity of 93.75% and a specificity of 86.67% for identifying IICP.

CONCLUSION:

ONSD as seen on bedside US correlated well with directly measured ICP in Korean adults with brain lesions. The optimal cut-off point of ONSD for detecting IICP was 5.6 mm.

PMID:
28902893
PMCID:
PMC5597178
DOI:
10.1371/journal.pone.0183170
[Indexed for MEDLINE]
Free PMC Article

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