Point-of-care ultrasound of optic nerve sheath diameter to detect elevated intracranial pressure: Ultrasound in the eye of the beholder?
Raised intracranial pressure (ICP) is a frequent complication in neurocritically-ill patients. Current diagnostic methods are invasive and have ample drawbacks. Ultrasound of ONSD can be an alternative modality to diagnose and monitor a raised ICP. A thorough search in PubMed/EMBASE was applied to find relevant articles. Two reviewers independently evaluated the relevant articles and extracted the data. The optimal cut-off value of ONSD to detect a raised ICP ranged from 4.7 – 5.7 mm with corresponding sensitivity and specificity rates ranging from 70% - 100% and 31.9% - 100%, respectively. Measurements of ultrasound ONSD showed to be less accurate in presence of fluctuations of ICP values. Ultrasound of ONSD is an accurate, safe, sensitive and specific method to detect a raised ICP. For now, ultrasound of ONSD has its limitations and must not be used as a primary modality to diagnose an elevated ICP and further research is needed.
|Keywords||Intracranial pressure, ONSD, Optic nerve sheath diameter, Ultrasound|
|Journal||Netherlands Journal of Critical Care|
Tjahjadi, N.S. (N. S.), Van De Bergh, W. (W.), Elbers, P.W.G, Gommers, D.A.M.P.J, & Tuinman, S. (2019). Point-of-care ultrasound of optic nerve sheath diameter to detect elevated intracranial pressure: Ultrasound in the eye of the beholder?. Netherlands Journal of Critical Care (Vol. 27, pp. 81–86). Retrieved from http://hdl.handle.net/1765/117581