Optic nerve sheath measurement and raised intracranial pressure in paediatric traumatic brain injury

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
S Agrawal, J Brierley

Abstract

The optimal management of children ventilated for more than 4 h with traumatic brain injury (TBI) necessitates invasive intracranial pressure (ICP) monitoring, though some patients never have raised ICP. If non-invasive screening can reliably rule out elevated ICP, invasive devices can be limited to those in whom neuro-intensive care measures are indicated. We measured the optic nerve sheath diameter (ONSD) with a 10-MHz ultrasound probe in 11 children (age range 2-15 years, median 9.2 years) with severe TBI admitted to a regional neuro-surgical paediatric intensive care unit (PICU) requiring ICP monitoring and neuro-protection. Simultaneous invasive ICP was recorded and more than 15 mmHg was considered to be abnormal. ONSD >4.5 mm in children over 1 year of age was considered to be abnormal. All children with clinically significantly raised ICP had abnormal ONSD, whereas those with normal ICP did not. Despite the small numbers, this study suggests that the ONSD may be useful in identifying children with TBI and normal ICP and, so, help avoid the insertion of unnecessary ICP monitors.

References

Apr 10, 1993·BMJ : British Medical Journal·G RennickJ de Campo
Dec 2, 1999·Clinical Radiology·J BallantyneG N Dutton
Jan 22, 2005·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Ashkan Akhavan MalayeriMehrzad Mehdizadeh
Jan 25, 2005·RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin·F KörberG Alzen
May 15, 2008·Critical Care : the Official Journal of the Critical Care Forum·Theodoros SoldatosAndreas Karabinis
May 30, 2008·Intensive Care Medicine·Thomas GeeraertsJacques Duranteau

❮ Previous
Next ❯

Citations

Feb 2, 2018·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Samuel S ShinMisun Hwang
Aug 17, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Vidit BhargavaErik Su
Nov 18, 2017·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Adam M H YoungPeter J Hutchinson

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.