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01-12-2019 | Hypotension | Review Article

Optic nerve sheath diameter: present and future perspectives for neurologists and critical care physicians

Authors: Piergiorgio Lochner, Marek Czosnyka, Andrea Naldi, Epameinondas Lyros, Paolo Pelosi, Shrey Mathur, Klaus Fassbender, Chiara Robba

Published in: Neurological Sciences | Issue 12/2019

Abstract

Background

Estimation of intracranial pressure (ICP) may be helpful in the management of neurological critically ill patients. It has been shown that ultrasonography of the optic nerve sheath diameter (ONSD) is a reliable tool for non-invasive estimation of increased intracranial pressure (ICP) at hospital admission or in intensive care. Less is known about the estimation of increased ICP and usefulness of ONSD in the prehospital setting. The aim of this review was to elucidate both prevailing and novel applications of ONSD for neurologists and critical care physicians.

Methods

In this review, we discuss the technique and the novel approach of ONSD measurement, the clinical applications of ONSD in neurology and critical care patients.

Results

ONSD measurement is simple, easy to learn, and has diverse applications. ONSD has utility for ICP measurement in intracranial hemorrhage and ischemic stroke, meningitis and encephalitis, and idiopathic intracranial hypertension (IIH). It is also valuable for lesser known syndromes, where an increase of ICP is postulated, such as acute mountain sickness and posterior reversible encephalopathy syndrome. ONSD changes develop in inflammatory or ischemic optic neuropathies. Some papers demonstrate the usefulness of ONSD studies in symptomatic intracranial hypotension.

Conclusions

ONSD is a safe and low-cost bedside tool with the potential of screening patients who need other neuroimaging and those who may need an invasive measurement of ICP.

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Title: Optic nerve sheath diameter: present and future perspectives for neurologists and critical care physicians
Authors: Piergiorgio Lochner
Marek Czosnyka
Andrea Naldi
Epameinondas Lyros
Paolo Pelosi
Shrey Mathur
Klaus Fassbender
Chiara Robba
Publication date: 01-12-2019
Publisher: Springer International Publishing
Keywords: Hypotension
Idiopathic Intracranial Hypertension
Intracranial Hypertension
Care
Posterior Reversible Encephalopathy Syndrome
Hypotension
Published in: Neurological Sciences / Issue 12/2019
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-019-04015-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Optic nerve sheath diameter: present and future perspectives for neurologists and critical care physicians

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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