ISSN: 2149-2247 | E-ISSN: 2149-2549
Erciyes Medical Journal Diagnostic and Clinical Predictive Value of Optic Nerve Sheath Diameter Measurement in Children with Increased Intracranial Pressure [Erciyes Med J]
Erciyes Med J. 2021; 43(6): 554-559 | DOI: 10.14744/etd.2021.43809

Diagnostic and Clinical Predictive Value of Optic Nerve Sheath Diameter Measurement in Children with Increased Intracranial Pressure

Özlem Tolu Kendir1, Hayri Levent YILMAZ1, Hüseyin Tuğsan Ballı2, Sinem Sari1, İlker Ünal3, Ahmet Kağan Özkaya1
1Department of Pediatrics, Emergency Care Unit, Çukurova University, Balcalı Hospital, Adana, Turkey,
2Department of Radiology, Çukurova University, Balcalı Hospital, Adana, Turkey,
3Department of Biostatistic, Çukurova University, Balcalı Hospital Health Application and Research Center, Adana, Turkey

Objective: In this study, we aimed to determine the diagnostic and clinical predictive value of optic nerve sheath diameter (ONSD) measurement in pediatric patients suspected of increased intracranial pressure (IICP) by comparing sonographic ONSD values with radiological parameters and controls.
Materials and Methods: In total, 57 pediatric patients with suspected IICP who underwent computed tomography (CT) scans were included in this prospective, observational study; meanwhile, 35 patients were included as controls. Measure-ments were obtained while the patients were in supine position with their eyes closed, and transbulbar images of both eyes were obtained via a 6–15 MHz linear probe. The CT scans were assessed by a radiologist blinded to sonographic mea-surements. Glasgow coma scale of patients, service where they were followed, clinical results, CT, and ONSD values were assessed in this study.
Results: In the patient group, 26 of the patients were girls (35.4%), and the mean age was 138±56 months (min-max: 82–194 months). Meanwhile, in the control group, 18 of the patients were girls (40.9%), and mean age was 151±45 months (min-max: 106–196 months). As per our findings, 31 patients (54.4%) presented with high-energy trauma. Mean ONSD was 0.5±0.07 cm in the patient group, whereas it was 0.3±0.02 cm in the control group (p=0.008). It was 0.55±0.07 cm in patients with cerebral edema (CE) on CT scan (p=0.013). Based on the presence of CE as detected via CT scan, cut-off value for measurement was determined to be 0.49 cm, with 83.33% sensitivity and 68.42% specificity (AUC: 0.784).
Conclusion: Optic nerve sheath measurement can be utilized to immediately support diagnosis and predict follow-up in the assessment of pediatric patients with ICP elevation

Keywords: Optic nerve sheath measurement, increased intracranial pressure, cerebral edema

Özlem Tolu Kendir, Hayri Levent YILMAZ, Hüseyin Tuğsan Ballı, Sinem Sari, İlker Ünal, Ahmet Kağan Özkaya. Diagnostic and Clinical Predictive Value of Optic Nerve Sheath Diameter Measurement in Children with Increased Intracranial Pressure. Erciyes Med J. 2021; 43(6): 554-559

Corresponding Author: Özlem Tolu Kendir, Türkiye
Manuscript Language: English
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