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Optic nerve sheath diameter as a quantitative parameter associated with the outcome in patients with traumatic brain injury undergoing hematoma removal

  • Original Article - Brain Trauma
  • Published:
Acta Neurochirurgica Aims and scope

Abstract

Purpose

To determine the association between optic nerve sheath diameter (ONSD) and outcome in patients with traumatic brain injury (TBI) who undergo hematoma removal (HR).

Methods

This study was a retrospective analysis of data from a single center between 2016 and 2021. Adult patients with TBI who underwent HR within 24 h after admission were included in this study. Preoperative and postoperative ONSD of the surgical side and the mean ONSD of both sides were measured for analysis. The primary outcome was mortality at 30 days. Receiver operating characteristic curve analysis was performed to calculate the area under the curve (AUC) and 95% confidence interval (CI) for 30 days mortality.

Results

Sixty-one patients were enrolled in the study. Among them, 48 (78.7%) survived for 30 days after admission. The AUC and 95% CI of the postoperative mean ONSD on both sides and postoperative/preoperative mean of the ONSD ratio on both sides were 0.884 [0.734–0.955] and 0.875 [0.751–0.942], respectively. The postoperative mean of both ONSDs of 6.0 mm had high accuracy as a cut-off value with a sensitivity of 85%, specificity of 83%, positive likelihood ratio (LR) of 5.0, and negative LR- of 0.18.

Conclusion

This study demonstrated that postoperative ONSD and the postoperative/preoperative ONSD ratio were associated with postoperative outcome in patients with TBI who underwent HR.

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Data availability

The data that support the findings of this study are available from the Saiseikai Research group, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available.

References

  1. Amini A, Kariman H, Arhami Dolatabadi A, Hatamabadi HR, Derakhshanfar H, Mansouri B, Safari S, Eqtesadi R (2013) Use of the sonographic diameter of optic nerve sheath to estimate intracranial pressure. Am J Emerg Med 31(1):236–239

    Article  PubMed  Google Scholar 

  2. Bekerman I, Sigal T, Kimiagar I, Ben EA, Vaiman M (2016) American Journal of Emergency Medicine The quantitative evaluation of intracranial pressure by optic nerve sheath diameter / eye diameter CT measurement ☆, ☆☆. Am J Emerg Med 34(12):2336–2342

    Article  PubMed  Google Scholar 

  3. Bland JM, Altman DG (1997) Cronbach’s alpha. BMJ 314(7080):572

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Carney N, Totten AM, O’Reilly C et al (2017) Guidelines for the management of severe traumatic brain injury. Fourth Edition Neurosurgery 80(1):6–15

    Article  PubMed  Google Scholar 

  5. Choi YH, Lim TK, Lee SG (2017) Clinical features and outcomes of bilateral decompression surgery for immediate contralateral hematoma after craniectomy following acute subdural hematoma. Korean J Neurotrauma 13(2):108–112

    Article  PubMed  PubMed Central  Google Scholar 

  6. Du J, Deng Y, Li H, Qiao S, Yu M, Xu Q, Wang C (2020) Ratio of optic nerve sheath diameter to eyeball transverse diameter by ultrasound can predict intracranial hypertension in traumatic brain injury patients: a prospective study. Neurocrit Care 32(2):478–485

    Article  PubMed  Google Scholar 

  7. Fletcher-Sandersjöö A, Thelin EP, Maegele M, Svensson M, Bellander BM (2021) Time course of hemostatic disruptions after traumatic brain injury: a systematic review of the literature. Neurocrit Care 34(2):635–656

    Article  PubMed  Google Scholar 

  8. Fujiwara G, Murakami M, Ishii W, Maruyama D, Iizuka R, Murakami N, Hashimoto N (2022) Effectiveness of administration of fibrinogen concentrate as prevention of hypofibrinogenemia in patients with traumatic brain injury with a higher risk for severe hyperfibrinolysis: single center before-and-after study. Neurocrit Care. https://doi.org/10.1007/s12028-022-01626-9

    Article  PubMed  Google Scholar 

  9. Fujiwara G, Okada Y, Sakakibara T, Yamaki T, Hashimoto N (2021) The association between D - dimer levels and long - term neurological outcomes of patients with traumatic brain injury : an analysis of a nationwide observational neurotrauma database in Japan. Neurocrit Care. https://doi.org/10.1007/s12028-021-01329-7

    Article  PubMed  Google Scholar 

  10. Grimes DA, Schulz KF (2005) Refining clinical diagnosis with likelihood ratios. Lancet 365(9469):1500–1505

    Article  PubMed  Google Scholar 

  11. Hanafi MG, Verki MM, Parei SN (2019) Ultrasonic assessment of optic nerve sheath to detect increased intracranial pressure. J Med Ultrasound 27(2):69–74

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hansen HC, Helmke K (1996) The subarachnoid space surrounding the optic nerves An ultrasound study of the optic nerve sheath. Surg Radiol Anat 18(4):323–328

    Article  CAS  PubMed  Google Scholar 

  13. Hayakawa M, Maekawa K, Kushimoto S et al (2016) High D-dimer levels predict a poor outcome in patients with severe trauma, even with high fibrinogen levels on arrival. Shock 45(3):308–314

    Article  CAS  PubMed  Google Scholar 

  14. Hayakawa M, Maekawa K, Kushimoto S et al (2016) High D-dimer levels predict a poor outcome in patients with severe trauma, even with high fibrinogen levels on arrival: a multicenter retrospective study. Shock 45(3):308–314

    Article  CAS  PubMed  Google Scholar 

  15. Jenjitranant P, Tunlayadechanont P, Prachanukool T, Kaewlai R (2020) Correlation between optic nerve sheath diameter measured on imaging with acute pathologies found on computed tomography of trauma patients. Eur J Radiol 125:108875

    Article  PubMed  Google Scholar 

  16. Jeon SB, Kwon SU, Park JC et al (2016) Reduction of midline shift following decompressive hemicraniectomy for malignant middle cerebral artery infarction. J Stroke 18(3):328–336

    Article  PubMed  PubMed Central  Google Scholar 

  17. Juratli TA, Zang B, Litz RJ, Sitoci K-H, Aschenbrenner U, Gottschlich B, Daubner D, Schackert G, Sobottka SB (2014) Early hemorrhagic progression of traumatic brain contusions: frequency, correlation with coagulation disorders, and patient outcome: a prospective study. J Neurotrauma 31(17):1521–1527

    Article  PubMed  Google Scholar 

  18. Kaur A, Gautam PL, Sharma S, Singh VP, Sharma S (2021) Bedside ultrasonographic assessment of optic nerve sheath diameter as a means of detecting raised intracranial pressure in neuro-trauma patients: a cross-sectional study. Ann Indian Acad Neurol 24(1):63–68

    PubMed  Google Scholar 

  19. Kavi T, Gupta A, Hunter K, Schreiber C, Shaikh H, Turtz AR (2018) Optic nerve sheath diameter assessment in patients with intracranial pressure monitoring. Cureus. https://doi.org/10.7759/cureus.3546

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kurland D, Hong C, Aarabi B, Gerzanich V, Simard JM (2012) Hemorrhagic progression of a contusion after traumatic brain injury: A review. J Neurotrauma 29(1):19–31

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lee SJ, Choi MH, Lee SE, Park JH, Park B, Lee JS, Hong JM (2020) Optic nerve sheath diameter change in prediction of malignant cerebral edema in ischemic stroke: an observational study. BMC Neurol 20(1):1–10

    Article  CAS  Google Scholar 

  22. Liugan M, Xu Z, Zhang M (2017) Reduced free communication of the subarachnoid space within the optic canal in the human. Am J Ophthalmol 179:25–31

    Article  PubMed  Google Scholar 

  23. Lochner P, Czosnyka M, Naldi A, Lyros E, Pelosi P, Mathur S, Fassbender K, Robba C (2019) Optic nerve sheath diameter: present and future perspectives for neurologists and critical care physicians. Neurol Sci Off J Ital Neurol Soc Ital Soc Clin Neurophysiol 40(12):2447–2457

    Google Scholar 

  24. Mallett S, Halligan S, Matthew Thompson GP, Collins GS, Altman DG (2012) Interpreting diagnostic accuracy studies for patient care. BMJ 345(7871):1–7

    Google Scholar 

  25. Mathews A, Cattamanchi S, Panneerselvam T, Trichur RV (2020) Evaluation of bedside sonographic measurement of optic nerve sheath diameter for assessment of raised intracranial pressure in adult head trauma patients. J Emerg Trauma Shock 13(3):190–195

    Article  PubMed  PubMed Central  Google Scholar 

  26. Matsuno A, Katayama H, Wada H, Morikawa K, Tanaka K, Tanaka H, Murakami M, Fuke N, Nagashima T (2003) Significance of consecutive bilateral surgeries for patients with acute subdural hematoma who develop contralateral acute epi- or subdural hematoma. Surg Neurol 60(1):23–30 (discussion 30)

    Article  PubMed  Google Scholar 

  27. Nakae R, Takayama Y, Kuwamoto K, Naoe Y, Sato H, Yokota H (2016) Time course of coagulation and fibrinolytic parameters in patients with traumatic brain injury. J Neurotrauma 33(7):688–695

    Article  PubMed  Google Scholar 

  28. Ohle R, McIsaac SM, Woo MY, Perry JJ (2015) Sonography of the optic nerve sheath diameter for detection of raised intracranial pressure compared to computed tomography: a systematic review and meta-analysis. J Ultrasound Med Off J Am Inst Ultrasound Med 34(7):1285–1294

    Google Scholar 

  29. Rafay M, Gulzar F, Iqbal N, Sharif S (2020) Prognostic computed tomography scores in traumatic brain injury. Clin Neurol Neurosurg 195(April):105957

    Article  PubMed  Google Scholar 

  30. Robba C, Graziano F, Rebora P et al (2021) Intracranial pressure monitoring in patients with acute brain injury in the intensive care unit (SYNAPSE-ICU): an international, prospective observational cohort study. Lancet Neurol 20(7):548–558

    Article  CAS  PubMed  Google Scholar 

  31. Robba C, Santori G, Czosnyka M, Corradi F, Bragazzi N, Padayachy L, Taccone FS, Citerio G (2018) Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: a systematic review and meta-analysis. Intensive Care Med 44(8):1284–1294

    Article  PubMed  Google Scholar 

  32. Sekhon MS, McBeth P, Zou J, Qiao L, Kolmodin L, Henderson WR, Reynolds S, Griesdale DEG (2014) Association between optic nerve sheath diameter and mortality in patients with severe traumatic brain injury. Neurocrit Care 21(2):245–252

    Article  PubMed  Google Scholar 

  33. Selhorst JB, Chen Y (2009) The optic nerve. Semin Neurol 29(1):29–35

    Article  PubMed  Google Scholar 

  34. Sheth S, Branstetter BF 4th, Escott EJ (2009) Appearance of normal cranial nerves on steady-state free precession MR images. Radiogr a Rev Publ Radiol Soc North Am Inc 29(4):1045–1055

    Google Scholar 

  35. Sitanaya SN, Kamayanti F, Nugroho HA, Prabowo B (2022) Comparing ultrasonographic optic nerve sheath diameter to head computed tomography scan to predict intracranial pressure elevation. SAGE Open Med 10:205031212210778

    Article  Google Scholar 

  36. Tian HL, Chen H, Wu BS, Cao HL, Xu T, Hu J, Wang G, Gao WW, Lin ZK, Chen SW (2010) D-dimer as a predictor of progressive hemorrhagic injury in patients with traumatic brain injury: analysis of 194 cases. Neurosurg Rev 33(3):359–366

    Article  PubMed  Google Scholar 

  37. Ueda T, Ishida E, Kojima Y, Yoshikawa S, Yonemoto H (2015) Sonographic optic nerve sheath diameter: a simple and rapid tool to assess the neurologic prognosis after cardiac arrest. J Neuroimaging 25(6):927–930

    Article  PubMed  Google Scholar 

  38. Verweij BH, Muizelaar JP, Vinas FC (2001) Hyperacute measurement of intracranial pressure, cerebral perfusion pressure, jugular venous oxygen saturation, and laser Doppler flowmetry, before and during removal of traumatic acute subdural hematoma. J Neurosurg 95(4):569–572

    Article  CAS  PubMed  Google Scholar 

  39. Waheed S, Baig MA, Siddiqui E, Jamil D, Bashar M, Feroze A (2018) Prognostic significance of optic nerve sheath diameter on computed tomography scan with severity of blunt traumatic brain injury in the emergency department. J Pak Med Assoc 68(2):268–271

    PubMed  Google Scholar 

  40. Wang J, Li K, Li H, Ji C, Wu Z, Chen H, Chen B (2020) Ultrasonographic optic nerve sheath diameter correlation with ICP and accuracy as a tool for noninvasive surrogate ICP measurement in patients with decompressive craniotomy. J Neurosurg 133(2):514–520

    Article  Google Scholar 

  41. Zhang J, He M, Song Y, Xu J (2018) Prognostic role of D-dimer level upon admission in patients with traumatic brain injury. Medicine (Baltimore) 97(31):e11774

    Article  CAS  PubMed  Google Scholar 

  42. Zhang X, Medow JE, Iskandar BJ, Wang F, Shokoueinejad M, Koueik J, Webster JG (2017) Invasive and noninvasive means of measuring intracranial pressure: a review. Physiol Meas 38(8):R143–R182

    Article  PubMed  Google Scholar 

  43. Zhao D-D, Guo Z-D, He S, Yin C (2020) High intracranial pressure may be the initial inducer of elevated plasma D-dimer level after aneurysmal subarachnoid haemorrhage. Int J Neurosci 130(7):694–699

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc, 2-4-1, Ohashi, Ritto, Shiga, 520-3046, Japan

    Gaku Fujiwara

  2. Department of Neurosurgery, Japanese Red Cross Society Kyoto Daini Hospital, Kyoto, Japan

    Gaku Fujiwara, Mamoru Murakami, Daisuke Maruyama & Nobukuni Murakami

  3. Department of Neurosurgery, Kyoto Tanabe Central Hospital, Kyoto, Japan

    Mamoru Murakami

  4. Department of Neurosurgery, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Daisuke Maruyama

Authors
  1. Gaku Fujiwara
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  4. Nobukuni Murakami
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Contributions

GF conceived the idea of this study. GF developed the statistical analysis plan and conducted statistical analyses. MM and DM contributed to the interpretation of the results. GF drafted the original manuscript. NM supervised this study. All authors reviewed the draft manuscript and revised it critically for intellectual content. All authors have approved the final version of the manuscript for publication.

Corresponding author

Correspondence to Gaku Fujiwara.

Ethics declarations

Ethics approval and consent to participate

The study was approved by the Clinical Research Ethics Committee of the Japanese Red Cross Society, Kyoto Daini Hospital (Approval ID Sp2022-12).

Informed consent

The ethics committee waived the requirement for informed consent because of the anonymity of data.

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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This article is part of the Topical Collection on Brain trauma

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Fujiwara, G., Murakami, M., Maruyama, D. et al. Optic nerve sheath diameter as a quantitative parameter associated with the outcome in patients with traumatic brain injury undergoing hematoma removal. Acta Neurochir 165, 281–287 (2023). https://doi.org/10.1007/s00701-022-05479-1

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  • DOI: https://doi.org/10.1007/s00701-022-05479-1

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