J Korean Soc Emerg Med.  2015 Feb;26(1):1-8. 10.0000/jksem.2015.26.1.1.

Availability of the Optic Nerve Sheath Diameter Measured by Using Facial CT as a Predictive Factor for Traumatic Brain Injury in the Emergency Department

• Choi HJ
• Moon HJ
• Lee JW
• Kim JH
• Jeong DK
• Kim KH
• Kim YK
• Ko MJ
• Choi JH

• KMID: 2191827
• DOI: http://doi.org/10.0000/jksem.2015.26.1.1

Abstract

PURPOSE
Traumatic brain injury (TBI) occurs frequently in patients with facial injuries. In patients with facial injuries without neurologic deficit, it is a challenging decision for emergency physicians whether brain computed tomography (CT) is necessary or not. Our objective is to evaluate the availability of optic nerve sheath diameter (ONSD) measured by facial CT in predicting TBI.
METHODS
From January, 2010, to December, 2012, we conducted a retrospective study of patients with head or facial injuries who underwent both facial CT and brain CT simultaneously in the emergency department. Patients with obvious orbital trauma or ocular disease were excluded. We analyzed correlation between ONSD measured by facial CT and the brain CT findings of TBI.
RESULTS
A total of 229 patients were enrolled. Ninety six patients without TBI on facial CT showed mean ONSD of 5.11+/-0.44 mm, and 82 patients with TBI showed mean ONSD of 5.89+/-0.78 mm. The sensitivity and the specificity compared with the presence of TBI findings on brain CT were 78.05% and 82.29%, respectively, when the cut-off value was set to 5.5 mm. The area under the curve (AUC) was 0.826 in the receiver operating characteristic curve (ROC curve).
CONCLUSION
ONSD measured on facial CT is available for predicting TBI in patients with facial injuries.

Keyword

Brain injury; Intracranial hypertension; X-ray Computed tomography; Facial injuries; Optic nerve

MeSH Terms

Brain
Brain Injuries*
Emergencies
Emergency Service, Hospital*
Facial Injuries
Head
Humans
Intracranial Hypertension
Neurologic Manifestations
Optic Nerve*
Orbit
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Tomography, X-Ray Computed