TY  - JOUR
PY  - 2022//
TI  - Perioperative variation in optic nerve sheath diameter - a prospective observational study of traumatic brain injury patients undergoing decompressive craniectomy
JO  - Neurology India
A1  - Suresh, Varun
A1  - Ushakumari, P. R.
A1  - Aggarwal, Anurag
A1  - Kumar, Arun
A1  - Kutty, Raja K.
A1  - Prabhakar, Rajmohan B.
A1  - Peethambaran, Anilkumar
SP  - 1460
EP  - 1467
VL  - 70
IS  - 4
N2  - BACKGROUND: Measuring optic nerve sheath diameter (ONSD) by transbulbar ultrasonography (TBUS) can suffice non-invasive ICP measurement with considerable accuracy. <br><br>OBJECTIVE: The primary objective of this study was to evaluate the perioperative variation in ONSD by TBUS in Traumatic Brain Injury (TBI) patients undergoing emergency craniectomy. <br><br>METHODS: We prospectively compared bilateral ONSD measurements in 45 consecutive TBI cases undergoing decompressive craniectomy under general anesthesia; before and after surgery. A total of 180 ONSD images were obtained and measurements were done by the same investigator blinded to the pre/postoperative nature of the image. <br><br>RESULTS: Based on preoperative Glasgow Coma Scores, 34 cases (75.5%) had severe TBI; 10 cases (22.2%) moderate TBI; and 1 case (2.2%) mild TBI. Preoperative ONSD in the study population were as 6.625 ± 0.414mm. Average ONSD reduced significantly by 0.249 ± 0.148 mm (P < 0.001) after craniectomy. On pooled analysis of cases undergoing right versus left sided craniectomy average ONSD reduced significantly by 0.252 ± 0.173 mm (P < 0.001) and 0.259 ± 0.139 mm (P < 0.001), respectively. ONSD of right eye with left eye and vice-versa were strongly correlated both pre/postoperatively with Pearson correlation coefficients (r)=0.879 (P < 0.001) and r = 0.827 (P < 0.001), respectively. <br><br>CONCLUSIONS: In TBI cases undergoing decompressive craniectomy ONSD is bilaterally increased preoperatively. ONSD reduces significantly immediately after craniectomy; however, the diameters did not near the normal range. There hold a strong correlation between right/left ONSD measurements irrespective of the laterality of injury or side of surgery. Variable elastic properties of ONS in an injured brain can possibly explain our findings.<p />  <p>Language: en</p>
LA  - en
SN  - 0028-3886
UR  - http://dx.doi.org/10.4103/0028-3886.355178
ID  - ref1
ER  -