J Korean Soc Emerg Med.  2017 Aug;28(4):334-344. 10.0000/jksem.2017.28.4.334.

Availability of the Optic Nerve Sheath Diameter Measured by Using Brain CT in Intracranial Hemorrhage

• Yu JK
• Kim YW
• Kang JH
• Yoon YS

• KMID: 2393977
• DOI: http://doi.org/10.0000/jksem.2017.28.4.334

Abstract

PURPOSE
This study was designed to evaluate the applicability of optic nerve sheath diameter (ONSD), as measured by a brain CT, in intracranial hemorrhage patients. We assumed that ONSD can be used to make surgical decisions and be considered as a predictive factor for mild intracranial hemorrhage (survival and neurologic outcomes) compared with the Glasgow Coma Scale (GCS) score.
METHODS
This retrospective study included 457 patients between January 2016 and September. They were divided into two groups: Those with GCS of between 13 and 15, and those with GCS of below 12. ONSD measurements were taken using a brain computed tomography in the axial view. Using SPSS Statistics ver. 20.0, ONSD was analyzed by a binary logistic regression analysis. Receiver operating characteristics (ROC) curves were used to find the cut-off value that maximized the sum of sensitivity and specificity in both groups to evaluate the feasibility of using ONSD for surgical decision and as a predictive factor (survival and neurologic outcomes).
RESULTS
The mean ONSD in mild hemorrhage patients was 5.43 mm. The odd ratio in the mild intracranial hemorrhage group for surgical decision was 5.030. The area under the ROC curve of mean ONSD in mild hemorrhage for surgical decision was 0.789. The cut-off value was 5.46 mm; sensitivity was 81.6% and Specificity was 75.0%. Positive and negative predictive values were 80.7% and 76.4%, respectively.
CONCLUSION
The mean ONSD, when compared with the GCS score, is a valuable factor for making surgical decisions in cases of mild intracranial hemorrhage.

Keyword

Intracranial hemorrhages; Intracranial pressure; Optic nerve; Glasgow Coma Scale

MeSH Terms

Brain*
Glasgow Coma Scale
Hemorrhage
Humans
Intracranial Hemorrhages*
Intracranial Pressure
Logistic Models
Optic Nerve*
Retrospective Studies
ROC Curve
Sensitivity and Specificity