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Hirzallah MI, Lochner P, Hafeez MU, Lee AG, Krogias C, Dongarwar D, Manchanda R, Ouellette L, Hartman ND, Ertl M, Schlachetzki F, Robba C. Quality assessment of optic nerve sheath diameter ultrasonography: Scoping literature review and Delphi protocol. J Neuroimaging 2022; 32:808-824. [PMID: 35711135 DOI: 10.1111/jon.13018] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE The optic nerve is surrounded by the extension of meningeal coverings of the brain. When the pressure in the cerebrospinal fluid increases, it causes a distention of the optic nerve sheath diameter (ONSD), which allows the use of this measurement by ultrasonography (US) as a noninvasive surrogate of elevated intracranial pressure. However, ONSD measurements in the literature have exhibited significant heterogeneity, suggesting a need for consensus on ONSD image acquisition and measurement. We aim to establish a consensus for an ONSD US Quality Criteria Checklist (ONSD US QCC). METHODS A scoping systematic review of published ultrasound ONSD imaging and measurement criteria was performed to guide the development of a preliminary ONSD US QCC that will undergo a modified Delphi study to reach expert consensus on ONSD quality criteria. The protocol of this modified Delphi study is presented in this manuscript. RESULTS A total of 357 ultrasound studies were included in the review. Quality criteria were evaluated under five categories: probe selection, safety, positioning, image acquisition, and measurement. CONCLUSIONS This review and Delphi protocol aim to establish ONSD US QCC. A broad consensus from this process may reduce the variability of ONSD measurements in future studies, which would ultimately translate into improved ONSD clinical applications. This protocol was reviewed and endorsed by the German Society of Ultrasound in Medicine.
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Affiliation(s)
- Mohammad I Hirzallah
- Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.,Center for Space Medicine, Baylor College of Medicine, Houston, Texas, USA
| | | | | | - Andrew G Lee
- Department of Ophthalmology, Houston Methodist Hospital, Houston, Texas, USA.,Department of Ophthalmology, Weill Cornell Medical College, New York, New York, USA
| | - Christos Krogias
- Department of Neurology, St Josef-Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Deepa Dongarwar
- Institutional Diversity & Student Services, Baylor College of Medicine, Houston, Texas, USA
| | - Ramneek Manchanda
- Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | | | - Nicholas D Hartman
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Michael Ertl
- Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany
| | - Felix Schlachetzki
- Department of Neurology, Center for Vascular Neurology and Intensive Care, University of Regensburg, Regensburg, Germany
| | - Chiara Robba
- Department of Anesthesia and Intensive Care, Policlinico San Martino, Genova, Italy
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Kermorgant M, Leca F, Nasr N, Custaud MA, Geeraerts T, Czosnyka M, Arvanitis DN, Senard JM, Pavy-Le Traon A. Impacts of Simulated Weightlessness by Dry Immersion on Optic Nerve Sheath Diameter and Cerebral Autoregulation. Front Physiol 2017; 8:780. [PMID: 29075198 PMCID: PMC5643847 DOI: 10.3389/fphys.2017.00780] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/25/2017] [Indexed: 11/13/2022] Open
Abstract
Dry immersion (DI) is used to simulate weightlessness. We investigated in healthy volunteers if DI induces changes in ONSD, as a surrogate marker of intracranial pressure (ICP) and how these changes could affect cerebral autoregulation (CA). Changes in ICP were indirectly measured by changes in optic nerve sheath diameter (ONSD). 12 healthy male volunteers underwent 3 days of DI. ONSD was indirectly assessed by ocular ultrasonography. Cerebral blood flow velocity (CBFV) of the middle cerebral artery was gauged using transcranial Doppler ultrasonography. CA was evaluated by two methods: (1) transfer function analysis was calculated to determine the relationship between mean CBFV and mean arterial blood pressure (ABP) and (2) correlation index Mxa between mean CBFV and mean ABP.ONSD increased significantly during the first day, the third day and the first day of recovery of DI (P < 0.001).DI induced a reduction in Mxa index (P < 0.001) and an elevation in phase shift in low frequency bandwidth (P < 0.05). After DI, Mxa and coherence were strongly correlated with ONSD (P < 0.05) but not before DI. These results indicate that 3 days of DI induces significant changes in ONSD most likely reflecting an increase in ICP. CA was improved but also negatively correlated with ONSD suggesting that a persistent elevation ICP favors poor CA recovery after simulated microgravity.
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Affiliation(s)
- Marc Kermorgant
- UMR Institut National de la Santé et de la Recherche Médicale 1048, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
| | - Florian Leca
- Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, Toulouse, France
| | - Nathalie Nasr
- UMR Institut National de la Santé et de la Recherche Médicale 1048, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France.,Department of Neurology and Institute for Neurosciences, University Hospital of Toulouse, Toulouse, France
| | - Marc-Antoine Custaud
- BNMI, UMR Institut National de la Santé et de la Recherche Médicale 1083, UMR Centre National de la Recherche Scientifique 6214, Centre de Recherche Clinique, University Hospital of Angers, Angers, France
| | - Thomas Geeraerts
- Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, Toulouse, France.,Toulouse NeuroImaging Center, UMR 1214, Institut National de la Santé et de la Recherche Médicale, Université Toulouse III-Paul Sabatier, Toulouse, France
| | - Marek Czosnyka
- Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge University Hospital, Cambridge, United Kingdom.,Institute of Electronic Systems, Warsaw University of Technology, Warsaw, Poland
| | - Dina N Arvanitis
- UMR Institut National de la Santé et de la Recherche Médicale 1048, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
| | - Jean-Michel Senard
- UMR Institut National de la Santé et de la Recherche Médicale 1048, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France.,Department of Neurology and Institute for Neurosciences, University Hospital of Toulouse, Toulouse, France
| | - Anne Pavy-Le Traon
- UMR Institut National de la Santé et de la Recherche Médicale 1048, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France.,Department of Neurology and Institute for Neurosciences, University Hospital of Toulouse, Toulouse, France
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Neuroréanimation pédiatrique: l’expérience afghane. MEDECINE INTENSIVE REANIMATION 2014. [DOI: 10.1007/s13546-014-0836-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Scrivani PV, Fletcher DJ, Cooley SD, Rosenblatt AJ, Erb HN. T2-WEIGHTED MAGNETIC RESONANCE IMAGING MEASUREMENTS OF OPTIC NERVE SHEATH DIAMETER IN DOGS WITH AND WITHOUT PRESUMED INTRACRANIAL HYPERTENSION. Vet Radiol Ultrasound 2013; 54:263-70. [DOI: 10.1111/vru.12023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2012] [Revised: 01/25/2013] [Accepted: 01/27/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
- Peter V. Scrivani
- From the Department of Clinical Sciences; Department of Population Medicine and Diagnostic Sciences; College of Veterinary Medicine, Cornell University; Ithaca; NY; 14853
| | - Daniel J. Fletcher
- From the Department of Clinical Sciences; Department of Population Medicine and Diagnostic Sciences; College of Veterinary Medicine, Cornell University; Ithaca; NY; 14853
| | - Stacy D. Cooley
- From the Department of Clinical Sciences; Department of Population Medicine and Diagnostic Sciences; College of Veterinary Medicine, Cornell University; Ithaca; NY; 14853
| | - Alana J. Rosenblatt
- From the Department of Clinical Sciences; Department of Population Medicine and Diagnostic Sciences; College of Veterinary Medicine, Cornell University; Ithaca; NY; 14853
| | - Hollis N. Erb
- From the Department of Clinical Sciences; Department of Population Medicine and Diagnostic Sciences; College of Veterinary Medicine, Cornell University; Ithaca; NY; 14853
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Intracranial pressure: why we monitor it, how to monitor it, what to do with the number and what's the future? Curr Opin Anaesthesiol 2011; 24:117-23. [PMID: 21293261 DOI: 10.1097/aco.0b013e32834458c5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW The review touches upon the current physiopathological concepts relating to the field of intracranial pressure (ICP) monitoring and offers an up-to-date overview of the ICP monitoring technologies and of the signal-analysis techniques relevant to clinical practice. RECENT FINDINGS Improved ICP probes, antibiotic-impregnated ventricular catheters and multimodality, computerized systems allow ICP monitoring and individualized optimization of brain physiology. Noninvasive technologies for ICP and cerebral perfusion pressure assessment are being tested in the clinical arena. Computerized morphological analysis of the ICP pulse-waveform can provide an indicator of global cerebral perfusion. SUMMARY Current recommendations for the management of traumatic brain injury indicate ICP monitoring in patients who remain comatose after resuscitation if the admission computed tomography scan reveals intracranial abnormalities such as haematomas, contusions and cerebral oedema. The most reliable methods of ICP monitoring are ventricular catheters and intraparenchymal systems. A growing number of these devices are being safely placed by neurointensivists. The consensus is to treat ICP exceeding the 20 mmHg threshold, and to target cerebral perfusion pressure between 50 and 70 mmHg. Recent evidence suggests that such thresholds should be optimized based on multimodality monitoring and individual brain physiology. Noninvasive ICP estimation using transcranial Doppler can have a role as a screening tool in patients with low to intermediate risk of developing intracranial hypertension. However, the technology remains insufficiently accurate and too cumbersome for continuous ICP monitoring.
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