ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2020
The relation of optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in pediatric neurosurgery practice - Part I: Correlations, age-dependency and cut-off values.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Intraindividual Optic Nerve Sheath Variation and Intracranial Pressure Changes: A Systematic Review and Meta-Analysis.Journal of neuroimaging : official journal of the American Society of NeuroimagingPooled it
- Ultrasonographic optic nerve sheath diameter for predicting elevated intracranial pressure and clinical severity in children: a prospective observational study.European journal of pediatrics · 2026Observational
- Comparison Between Ultrasound and Magnetic Resonance Imaging Measurements of the Optic Nerve Sheath Diameter in Patients Undergoing Intracranial Surgery: Prospective Observational Single-Center Study.JMIR perioperative medicine · 2026Observational
- Optic nerve changes detected with ocular ultrasonography during epiduroscopy: a narrative review.Frontiers in surgery · 2026Review
- Article
- Optic nerve sheath diameter measurements monitor the impact of venous sinus stenosis and surgery on intracranial pressure in NF2 meningioma patients.Scientific reports · 2025Article
- Point of care ultrasound assessment of the optic nerve sheath diameter in critically ill children.BMC pediatrics · 2025Observational
- Measuring optic nerve sheath diameter in children: a simple ultrasound protocol for ICP assessment.Frontiers in pediatrics · 2025Article
- Evaluation of monitoring critical ill children with traumatic brain injury.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Article
- Application of ultrasound measurement of optic nerve sheath diameter to guide hyperosmolar therapy in children with intracranial hypertension.Frontiers in pediatrics · 2025Article
- Evaluation of optic nerve sheath diameter measurements in postictal pediatric patients.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Optic nerve sheath diameter as a non-invasive tool to detect clinically relevant raised intracranial pressure in children: an observational analytical study.BMJ paediatrics open · 2024Observational
- Optic nerve sheath diameter correlates with both success and failure of hydrocephalus treatment in pediatric patients with pineal region lesions.Acta neurochirurgica · 2024Article
- Ultrasound-guided initial diagnosis and follow-up of pediatric idiopathic intracranial hypertension.Pediatric radiology · 2024Article
- Transorbital point-of-care ultrasound versus fundoscopic papilledema to support treatment indication for potentially elevated intracranial pressure in children.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Influence of sex and disease etiology on the development of papilledema and optic nerve sheath extension in the setting of intracranial pressure elevation in children.Brain & spine · 2024Article
- Optic nerve sheath diameter and its association with brain swelling in pediatric cerebral malaria: a retrospective study.Frontiers in pediatrics · 2024Article
- Non-Invasive Quantitative Approximation of Intracranial Pressure in Pediatric Idiopathic Intracranial Hypertension Based on Point-of-Care Ultrasound of the Optic Nerve Sheath Diameter.Brain sciences · 2023Article
- Venous 3D Phase Contrast Magnetic Resonance Angiography Increases Diagnostic Certainty in Children with Ventriculoperitoneal Shunt and Suspected Shunt Failure.Clinical neuroradiology · 2023Article
- Variability of the optic nerve sheath diameter on brain computed tomography in Turkish children based on sex and age.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Article
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeIt is assumed that the width of the optic nerve sheath diameter (ONSD) is dependent on intracranial pressure (ICP) and pulsatility and thus constitutes a non-invasively accessible "window" for qualitative assessment of ICP. Data on the correlation to invasively measured ICP in children are scarce and have often been obtained from sedated patients in intensive care unit (ICU) or intraoperatively. We report on a mixed cohort of pediatric neurosurgical patients, ICP and ONSD measurements were available from both sedated and awake children, only a minority from ICU patients.
methodsSeventy-two children were investigated. Ultrasound ONSD determination was performed immediately prior to invasive ICP measurement and the mean binocular ONSD was compared with ICP. The investigations were performed in children awake, sedated, or under general anesthesia.
resultsIn the entire patient cohort, the correlation between ONSD and ICP was good (r = 0.52, p < 0.01). Children > 1 year revealed a better correlation (r = 0.63; p < 0.01) and those ≤ 1 year did worse (r = 0.21). Infants with open fontanelle had no correlation. In the entire cohort, the best ONSD cut-off value for detecting ICP ≥ 15 and ≥ 20 mmHg was 5.28 and 5.57 mm (OR 22.5 and 7.2, AUC 0.782 and 0.733).
conclusionTransorbital ultrasound measurement of ONSD is a reliable non-invasive technique to assess increased ICP in children in every clinical situation; however, the impact of age and fontanelle status needs to be considered. ONSD thresholds enable qualitative first orientation regarding ICP categories with a very satisfying diagnostic accuracy.
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