ArticleFrontiers in neurology2026
Derivative indices of optic nerve sheath diameter: a novel ultrasound-based approach for non-invasive intracranial pressure monitoring in neurocritical patients.
Article in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Preoperative intracranial pressure (ICP) evaluation in neurocritical patients relies on computed tomography (CT) findings, which often lack accuracy. Ultrasound-measured optic nerve sheath diameter (ONSD) offers a non-invasive alternative, but optimal measurement protocols and indices remain controversial. Methods: We conducted a retrospective cohort study of 45 neurocritical patients undergoing emergency craniotomy with invasive ICP monitoring between January 2023 and December 2025. Preoperative ultrasound measured ONSDint, ONSDext, and 8 derivative indices. Pearson correlation analysis, receiver operating characteristic (ROC) curves, and Kappa consistency tests were used to validate associations with invasive ICP measurements. Results: All ONSD-derived indices correlated significantly with invasive ICP ( Conclusion: ONSDint/OND and ONSDint-OND are reliable non-invasive biomarkers for predicting elevated ICP in neurocritical patients, providing valuable information to guide preoperative surgical decision-making. This study validates the clinical utility of ultrasound-derived ONSD indices in optimizing ICP assessment before craniotomy.
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