Transorbital Ultrasonographic Measurement of Optic Nerve Sheath Diameter for Intracranial Midline Shift in Patients with Head Trauma.
OBJECTIVE
Measurement of the optic nerve sheath diameter (ONSD) by using sonography is a straightforward, noninvasive technique to detect an increased intracranial pressure, which can even be conducted at the bedside. However, the correlation between ONSD and intracranial midline shift has not been studied.


METHODS
The authors performed a prospective, blinded observational study in an intensive care unit. Forty-five patients were divided into groups. Of those, 19 patients had a midline shift, whereas 26 had no intracranial pathology or shift and served as control individuals.


RESULTS
Spearman rank correlation coefficient of difference of ONSD and midline shift was 0.761 (P < 0.0005), demonstrating a significant positive correlation between patients with midline shift and control group.


CONCLUSIONS
Despite small numbers and selection bias, this study suggests that bedside ultrasound may be useful in the diagnosis of midline intracranial shift by measurement of ONSD.
Department of Anesthesiology and Reanimation, Recep Tayyip Erdogan University, Rize, Turkey.
Hizir
H
Kazdal
Department of Neurosurgery, Recep Tayyip Erdogan University, Rize, Turkey. Electronic address: ayhankanat@yahoo.com.
Ayhan
A
Kanat
Department of Ophthalmology, Recep Tayyip Erdogan University, Rize, Turkey.
Huseyin
H
Findik
Department of Anesthesiology and Reanimation, Recep Tayyip Erdogan University, Rize, Turkey.
Ahmet
A
Sen
Department of Neurosurgery, Recep Tayyip Erdogan University, Rize, Turkey.
Bulent
B
Ozdemir
Department of Neurosurgery, Recep Tayyip Erdogan University, Rize, Turkey.
Osman Ersegun
OE
Batcik
Department of Emergency Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Ozcan
O
Yavasi
Department of Radiology, Recep Tayyip Erdogan University, Rize, Turkey.
Mehmet Fatih
MF
Inecikli
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000000981:diagnostic imaging; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging*; D004453:Echoencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D020198:Intracranial Hemorrhage, Traumatic / Q000000981:diagnostic imaging; D019586:Intracranial Hypertension / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009186:Myelin Sheath / Q000000981:diagnostic imaging*; D009900:Optic Nerve / Q000000981:diagnostic imaging*; D000067716:Point-of-Care Testing; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity
Intensive care unit; Intracranial midline shift; Optic nerve sheath diameter; Transorbital ultrasound