open access

Vol 4, No 1 (2019)
Review paper
Published online: 2019-05-24
Get Citation

Ultrasound assessment of the optic nerve sheath as an indirect method of diagnosis of increased intracranial pressure

Kurt Ruetzler1, Maciej Dudek2, Dominka Dunder2, Lukasz Szarpak2
·
Disaster Emerg Med J 2019;4(1):14-17.
Affiliations
  1. Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, USA; Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, USA
  2. Lazarski University, Warsaw, Poland

open access

Vol 4, No 1 (2019)
REVIEW ARTICLES
Published online: 2019-05-24

Abstract

Ultrasonography is a diagnostic technique that has been used clinically for 30 years. Due to the increased availability of ultrasound machines as well as the reduction of their size and making them more mobile, ultrasound has found its place in early diagnosis in emergency medicine settings. One of the important, however, an underestimated ultrasound examination is the measurement of the thickness of the optic nerve sheath. The optic nerve is the second cranial nerve, meaning the same sheath surrounds it as the brain. At the moment of intracranial pressure increase, cerebrospinal fluid flows into the subarachnoid space causing an increase in intracranial pressure and thus increasing the diameter of the optic nerve sheath. therefore, ONSD imaging is a quick non-invasive test aimed at detecting and monitoring changes in intracranial pres- sure. Optic nerve sheath ultrasound is a simple, safe and inexpensive bedside diagnostic test. Ophthalmic ultrasound usually uses the frequency between 5 and 10.5 MHz to evaluate the eye and the orbit.  

Abstract

Ultrasonography is a diagnostic technique that has been used clinically for 30 years. Due to the increased availability of ultrasound machines as well as the reduction of their size and making them more mobile, ultrasound has found its place in early diagnosis in emergency medicine settings. One of the important, however, an underestimated ultrasound examination is the measurement of the thickness of the optic nerve sheath. The optic nerve is the second cranial nerve, meaning the same sheath surrounds it as the brain. At the moment of intracranial pressure increase, cerebrospinal fluid flows into the subarachnoid space causing an increase in intracranial pressure and thus increasing the diameter of the optic nerve sheath. therefore, ONSD imaging is a quick non-invasive test aimed at detecting and monitoring changes in intracranial pres- sure. Optic nerve sheath ultrasound is a simple, safe and inexpensive bedside diagnostic test. Ophthalmic ultrasound usually uses the frequency between 5 and 10.5 MHz to evaluate the eye and the orbit.  

Get Citation

Keywords

ultrasound test; emergency medicine; intracranial pressure; optic nerve

About this article
Title

Ultrasound assessment of the optic nerve sheath as an indirect method of diagnosis of increased intracranial pressure

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 4, No 1 (2019)

Article type

Review paper

Pages

14-17

Published online

2019-05-24

Page views

802

Article views/downloads

696

DOI

10.5603/DEMJ.2019.0004

Bibliographic record

Disaster Emerg Med J 2019;4(1):14-17.

Keywords

ultrasound test
emergency medicine
intracranial pressure
optic nerve

Authors

Kurt Ruetzler
Maciej Dudek
Dominka Dunder
Lukasz Szarpak

References (18)
  1. Ohle R, McIsaac SM, Woo MY, et al. Sonography of the Optic Nerve Sheath Diameter for Detection of Raised Intracranial Pressure Compared to Computed Tomography: A Systematic Review and Meta-analysis. J Ultrasound Med. 2015; 34(7): 1285–1294.
  2. Hylkema C. Optic Nerve Sheath Diameter Ultrasound and the Diagnosis of Increased Intracranial Pressure. Crit Care Nurs Clin North Am. 2016; 28(1): 95–99.
  3. Dudek M, Szarpak L, Ruetzler K. Application of interventional ultrasound in emergency medicine conditions. Disaster and Emergency Medicine Journal. 2018; 3(4): 137–147.
  4. Goel RS, Goel P. Optic nerve sheath diameter as ICP marker. J Neurosurg. 2016; 124(3): 890–891.
  5. Thotakura AK, Marabathina NR, Danaboyina AR, et al. Role of serial ultrasonic optic nerve sheath diameter monitoring in head injury. Neurochirurgie. 2017; 63(6): 444–448.
  6. Dubourg J, Javouhey E, Geeraerts T, et al. Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med. 2011; 37(7): 1059–1068.
  7. Canakci Y, Koksal O, Durak VA. The value of bedside ocular ultrasound assessment of optic nerve sheath diameter in the detection of increased intracranial pressure in patients presenting to the emergency room with headache. Niger J Clin Pract. 2018; 21(6): 778–782.
  8. Oberfoell S, Murphy D, French A, et al. Inter-rater Reliability of Sonographic Optic Nerve Sheath Diameter Measurements by Emergency Medicine Physicians. J Ultrasound Med. 2017; 36(8): 1579–1584.
  9. Aksoy Y, Eyi YE. The Bedside Ultrasound: A Rapid Way of Measuring Optic Nerve Sheath Diameter in Emergency. J Emerg Med. 2016; 51(2): e25–e26.
  10. Karami M, Shirazinejad S, Shaygannejad V, et al. Transocular Doppler and optic nerve sheath diameter monitoring to detect intracranial hypertension. Adv Biomed Res. 2015; 4: 231.
  11. Pal A, Dhar P, Goyal N. Perioperative monitoring of intracranial pressure using optic nerve sheath diameter in paediatric liver transplantation. Indian J Anaesth. 2018; 62(11): 892–895.
  12. Terkawi AS, Karakitsos D, Elbarbary M, et al. Ultrasound for the anesthesiologists: present and future. ScientificWorldJournal. 2013; 2013: 683685.
  13. Kane SC, Khong SuL, da Silva Costa F. Diagnostic Imaging: Ultrasound. Methods Mol Biol. 2018; 1710: 1–8.
  14. Betcher J, Becker TK, Stoyanoff P, et al. Military trainees can accurately measure optic nerve sheath diameter after a brief training session. Mil Med Res. 2018; 5(1): 42.
  15. Szarpak Ł, Truszewski Z, Kurowski A, et al. Knowledge, attitude, and practices of paramedics regarding optic nerve sheath diameter ultrasonography. Am J Emerg Med. 2016; 34(6): 1160–1161.
  16. Shirodkar CG, Munta K, Rao SM, et al. Correlation of measurement of optic nerve sheath diameter using ultrasound with magnetic resonance imaging. Indian J Crit Care Med. 2015; 19(8): 466–470.
  17. Yesilaras M, Kilic TY, Yesilaras S, et al. The diagnostic and prognostic value of the optic nerve sheath diameter on CT for diagnosis spontaneous subarachnoid hemorrhage. Am J Emerg Med. 2017; 35(10): 1408–1413.
  18. Zeiler FA, Ziesmann MT, Goeres P, et al. A unique method for estimating the reliability learning curve of optic nerve sheath diameter ultrasound measurement. Crit Ultrasound J. 2016; 8(1): 9.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl