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

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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.


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.  

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