The Contribution of Measuring the Optic Nerve Sheath Diameter by using Ultrasonography to the Diagnosis and Monitoring of Intracranial Hypertension

Abstract

Background: Intracranial hypertension, which may have a number of different causes, is a medical emergency. Although difficult to identify due to non-specific symptoms, it must be treated appropriately. An early sign of intracranial hypertension is an increase is observed in the optic nerve sheath diameter. . Ultrasonography is a rapid and easy-to-apply method to detect an increase in optic nerve sheath diameter, and may be useful for the emergency diagnosis and treatment, as well as contributing to clinical follow-up. Case Presentation: In the present study, seven patients with clinical suspicion for rapid intracranial pressure were admitted. Clinical scenarios included traffic accident, metabolic imbalance, infection, and intracranial mass. The pediatric emergency specialist performed optic nerve sheath measurement by using ultrasonography and a dilatation was detected. All measurements were taken by the certified and experienced pediatric emergency specialist blinded to the patient's clinical state and also the specialist was under observation of a lecturer during the measurements. Except for one patient, the control optic sheath diameter measurements were performed in the period, when they had no complaint, and the values were determined to be normal. To our knowledge, this case series is the first one examined in Turkey. The data from cases was collected between 2015 and 2016. Conclusion: Optic nerve sheath diameter measurement is a non-invasive method that offers ease of diagnosis and follow-up of suspected intracranial hypertension.