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Original article
Submitted: 2021-08-20
Accepted: 2021-09-24
Published online: 2021-10-21
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Optic nerve sheath diameter measurement: a means of detecting increased intracranial pressure in pseudotumor cerebri patients

T. Ertekin1, M. G. Boyaci2, A. Bilir1, A. Yucel3, A. Ertekin4, O. Turamanlar1, R. Duman5
DOI: 10.5603/FM.a2021.0105
·
Pubmed: 34699056
Affiliations
  1. Department of Anatomy, School of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
  2. Department of Neurosurgery School of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
  3. Department of Radiology, School of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
  4. Emergency Medicine Afyonkarahisar, School of Medicine, Afyonkarahisar Health Sciences University, Turkey
  5. Department of Opthalmology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey

open access

Ahead of Print
ORIGINAL ARTICLES
Submitted: 2021-08-20
Accepted: 2021-09-24
Published online: 2021-10-21

Abstract

Background: Pseudotumor cerebri (PTC) occurs when the pressure inside the skull increases for no obvious reason. The aim of this study was to investigate three different methods: the optic nerve sheath diameter (ONSD) method, ONSD/eyeball transverse diameter (ETD) index, and ONSD/orbital transverse diameter (OTD) index for the initial detection of elevated ICP in patients with PTC. Materials and methods: A retrospective study of MR data from adult PTC patients (n=42) and control group (n=40) was performed. ONSD and OTD measurements were made 3mm and 10mm posterior to the globe, after intracranial pressure was measured with lumbar puncture. The sensitivity, specificity, and overall accuracy of the findings on MRI were calculated. Results: The optic nerve sheath was enlarged in the PTC group compared with the control group. It showed 97%sensitivity and 100% specificity and 79% sensitivity and 87.5% specificity for 3mm and 10mm, respectively. The ONSD/ETD and ONSD/OTD indices were increased in the PTC group compared with the control group. For 3mm posterior to the globe, the ONSD/ETD index had 90.5% sensitivity and 92% specificity, and the ONSD/OTD index had 86% sensitivity and 95% specificity. For 10mm posterior to the globe, the sensitivity and specificity of the ONSD/ETD and ONSD/OTD indices were 86% and 80% and 74% and 82.5%, respectively. Conclusions: According to our study, the ONSD method and the ONSD/ETD and ONSD/OTD indices are reliable diagnostic markers for PTC. These noninvasive techniques may be useful in monitoring the invasive intracranial catheter and have wide potential clinical applications in district hospitals, emergency departments and intensive care units.

Abstract

Background: Pseudotumor cerebri (PTC) occurs when the pressure inside the skull increases for no obvious reason. The aim of this study was to investigate three different methods: the optic nerve sheath diameter (ONSD) method, ONSD/eyeball transverse diameter (ETD) index, and ONSD/orbital transverse diameter (OTD) index for the initial detection of elevated ICP in patients with PTC. Materials and methods: A retrospective study of MR data from adult PTC patients (n=42) and control group (n=40) was performed. ONSD and OTD measurements were made 3mm and 10mm posterior to the globe, after intracranial pressure was measured with lumbar puncture. The sensitivity, specificity, and overall accuracy of the findings on MRI were calculated. Results: The optic nerve sheath was enlarged in the PTC group compared with the control group. It showed 97%sensitivity and 100% specificity and 79% sensitivity and 87.5% specificity for 3mm and 10mm, respectively. The ONSD/ETD and ONSD/OTD indices were increased in the PTC group compared with the control group. For 3mm posterior to the globe, the ONSD/ETD index had 90.5% sensitivity and 92% specificity, and the ONSD/OTD index had 86% sensitivity and 95% specificity. For 10mm posterior to the globe, the sensitivity and specificity of the ONSD/ETD and ONSD/OTD indices were 86% and 80% and 74% and 82.5%, respectively. Conclusions: According to our study, the ONSD method and the ONSD/ETD and ONSD/OTD indices are reliable diagnostic markers for PTC. These noninvasive techniques may be useful in monitoring the invasive intracranial catheter and have wide potential clinical applications in district hospitals, emergency departments and intensive care units.

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Keywords

intracranial pressure, neurosurgery, optic nerve, pseudotumor cerebri, radiology

About this article
Title

Optic nerve sheath diameter measurement: a means of detecting increased intracranial pressure in pseudotumor cerebri patients

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Original article

Published online

2021-10-21

DOI

10.5603/FM.a2021.0105

Pubmed

34699056

Keywords

intracranial pressure
neurosurgery
optic nerve
pseudotumor cerebri
radiology

Authors

T. Ertekin
M. G. Boyaci
A. Bilir
A. Yucel
A. Ertekin
O. Turamanlar
R. Duman

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