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Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition
Published on: August 18, 2023
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Optic nerve sheath diameter ultrasonography for elevated intracranial pressure detection
Li-Juan Wang1, Hong-Xiu Chen1, Ying Chen1
1Department of Neurology, The First Hospital of Jilin University, Changchun, China.
Annals of Clinical and Translational Neurology
|May 9, 2020
Summary
Bedside ultrasonography of the optic nerve sheath diameter is a reliable method for detecting elevated intracranial pressure. This noninvasive technique proved more accurate than lumbar puncture in a case of subarachnoid hemorrhage with intracranial infection.
Area of Science:
- Neurology
- Neurosurgery
- Ophthalmology
Background:
- Elevated intracranial pressure (ICP) is a critical condition often diagnosed invasively.
- Optic nerve sheath diameter (ONSD) ultrasonography offers a noninvasive alternative for ICP assessment.
Observation:
- A patient with aneurysmal subarachnoid hemorrhage developed postoperative arachnoiditis.
- Lumbar puncture indicated low ICP, contradicting clinical suspicion of elevated ICP.
- Ultrasonography revealed a dilated ONSD, suggesting elevated ICP.
Findings:
- Computed tomography confirmed ventricular dilation, supporting elevated ICP.
- Ophthalmoscopy showed papilledema and hemorrhage, consistent with elevated ICP.
- Ultrasonographic ONSD measurement accurately detected elevated ICP, outperforming lumbar puncture in this complex case.
Implications:
- Noninvasive ONSD ultrasonography is a valuable tool for managing elevated ICP, particularly in the presence of intracranial infection.
- This case highlights the limitations of lumbar puncture in specific clinical scenarios.
- Bedside ONSD measurement enhances diagnostic accuracy and patient management in neurocritical care.
