Abstract
BackgroundThe optic nerve sheath diameter (ONSD) and ONSD/eyeball transverse diameter (ETD) ratio have been proven to be correlated with intracranial pressure. This study aimed to evaluate the prognostic roles of ONSD and the ONSD/ETD ratio in comatose patients with supratentorial lesions and to determine the relationship of these two indices with the prognosis of such patients.MethodsA total of 54 comatose patients with supratentorial lesions and 50 healthy controls were retrospectively included in this study. ONSD and ETD were measured by unenhanced computed tomography (CT). The differences in ONSD and the ONSD/ETD ratio between the two groups were compared. The prognosis of comatose patients was scored using the Glasgow Outcome Scale (GOS) at the 3-month follow-up, and these patients were classified into good (GOS score ≥ 3) and poor (GOS score < 3) prognosis groups. The differences in ONSD and the ONSD/ETD ratio were compared between comatose patients with good prognoses and those with poor prognoses.ResultsThe ONSD and ONSD/ETD ratios in the comatose patients were 6.30 ± 0.60 mm and 0.27 ± 0.03, respectively, and both were significantly greater than those in the healthy controls (5.10 ± 0.47 mm, t = 11.426, P < 0.0001; 0.22 ± 0.02, t = 11.468, P < 0.0001; respectively). ONSD in patients with poor prognosis was significantly greater than that in patients with good prognosis (6.40 ± 0.56 vs. 6.03 ± 0.61 mm, t = 2.197, P = 0.032). The ONSD/ETD ratio in patients with poor prognosis was significantly greater than that in patients with good prognosis (0.28 ± 0.02 vs. 0.26 ± 0.03, t = 2.622, P = 0.011). The area under the receiver operating characteristic (ROC) curve, used to predict the prognosis of comatose patients, was 0.650 (95% confidence interval (CI): 0.486–0.815, P = 0.078) for ONSD and 0.711 (95% CI: 0.548–0.874, P = 0.014) for the ONSD/ETD ratio.ConclusionsThe ONSD and ONSD/ETD ratios were elevated in comatose patients. The ONSD/ETD ratio might be more valuable than ONSD in predicting the prognoses of comatose patients with supratentorial lesions.
Highlights
The optic nerve sheath diameter (ONSD) and ONSD/eyeball transverse diameter (ETD) ratio have been proven to be correlated with intracranial pressure
The inclusion criteria were as follows: 1) patients aged ≥ 18 and ≤ 80 years old; 2) supratentorial lesions detected by unenhanced computed tomography (CT), including acute cerebral infarction (ACI), cerebral haemorrhage (CH), subarachnoid haemorrhage (SAH), and traumatic brain injury (TBI); and 3) comatose patients with Glasgow coma scale (GCS) scores ≤ 8 upon admission
Clinical characteristics A total of 54 comatose patients with supratentorial lesions and 50 healthy controls were included in this study
Summary
The optic nerve sheath diameter (ONSD) and ONSD/eyeball transverse diameter (ETD) ratio have been proven to be correlated with intracranial pressure. This study aimed to evaluate the prognostic roles of ONSD and the ONSD/ETD ratio in comatose patients with supratentorial lesions and to determine the relationship of these two indices with the prognosis of such patients. Diverse causes of coma have been reported, such as hypoxic ischaemic encephalopathy (HIE), traumatic brain injury (TBI), cerebrovascular disease, brain tumours, infection, inflammation, etc. Supratentorial lesions refer to diseases above the tentorium of the cerebellum that might elevate intracranial pressure (ICP). Brain herniation occurs when increased ICP causes abnormal protrusion of brain tissue through openings in rigid intracranial barriers (e.g., the tentorial notch). Monitoring of ICP is important for comatose patients with supratentorial lesions, assisting clinicians in making robust decisions
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
