Comparative study between ultrasound guided coronal versus axial optic nerve sheath diameter measurement in patients at risk of increased intracranial pressure

Abstract

Background: This work intended to contrast the effectiveness as well as precision of ultrasound guided coronal versus axial optic nerve sheath diameter (ONSD) measurement in patients at danger of elevated intracranial pressure (ICP). The optic nerve is a tubular structure of approximately 5 cm in Length, in which its intraorbital segment is evaluable sonographically. Methods: The 70 patients in this prospective, randomised, double-blinded trial spanned in age from 18 to 60 and had moderately to grave traumatic brain injury (TBI) when they were transferred to the intensive care unit (ICU) with a GCS of 3-12. There were two groups of patients: Patients in Group A do not exhibit elevated ICP readings on brain CT scans. Group B: Patients who had elevated ICP found on a brain CT scan. Results: There were non-significant higher mean coronal ONSD in comparison to mean axial ONSD in both groups. significant higher mean ONSD and mean axial and coronal ONSD in patients of group B. The Glasgow Coma Scale (GCS) was considerably lower in group B patients. In addition, there was a substantial inverse correlation between the mean ONSD, mean coronal and axial ONSD (mm), and the GCS for patients in both categories. Conclusions: In patients with trauma to the brain, monitoring the diameter of the optic nerve sheath with bedside ocular ultrasonography is a beneficial non-invasive way to detect excessive intracranial pressure earlier and correlation via the two methods (axial and coronal) gives us more accurate measurements.