Evaluation of Optic Nerve Sheath Diameter Measurement in the Management of Patients Admitted to the Emergency Department with Head Trauma

Abstract

Objective: Ultrasonographic measurements of optic nerve sheath diameter is associated with increased intracranial pressure. Intracranial pressure measurements are usually performed on critical areas or intensive care unit patients. The effect of ultrasonographic measurement of optic nerve sheath diameter in predicting pathology or the need for surgery in mild or moderate head trauma has not been evaluated. In our study, we compared ultrasonographic optic nerve sheath diameter measurements with cranial computed tomography (CT) findings and clinical outcomes of patients with head trauma. Materials and methods: Patients with head trauma admitted to the emergency department who were diagnosed with mild, moderate, and severe brain injury were selected for this retrospective study. The optic nerve sheath diameters were measured by ultrasonography. The findings were compared with the outcome and cranial tomography characteristics of the patients. Results: Of the 58 patients admitted to the emergency department with head trauma, mild traumatic brain injury was most common. Hospitalization or operation was required in 51.7% of the patients (30 patients). The mean optic nerve sheath diameter was 4.96 ± 1.02 mm (3.1–7.3 mm) on the right and 4.92 ± 1.02 mm (3.3–7.8) on the left. Optic nerve sheath diameter of 5 mm or more were statistically significant in predicting hospitalization, the presence of pathology, and increased intracranial pressure on cranial CT (P < 0.05). Conclusion: Optic nerve sheath diameters of patients with moderate and mild head trauma may provide information about the need for hospitalization or surgery and can be used as a triage criterion in determining the need for monitoring and follow-up and imaging priorities.