The Significance of Ultrasonographic Measurement of Optic Nerve Sheath Diameter in Assessing Cerebral Edema and Intracranial Hypertension in Neurocritical Care Patients
DOI:
https://doi.org/10.51699/93fpa167Keywords:
cerebral edema, intracranial hypertension, intracranial pressure, optic nerve sheath diameter, ultrasonography, computed tomography, neurocritical careAbstract
Cerebral edema and intracranial hypertension are among the life-threatening complications in critically ill neurological patients, and their timely detection and dynamic monitoring are of particular importance in neurocritical care. In cases where invasive intracranial pressure monitoring is unavailable or technically infeasible, the use of non-invasive methods becomes especially important. Ultrasonographic measurement of the optic nerve sheath diameter (ONSD) is considered a bedside method that allows indirect assessment of increased intracranial pressure. In this study, the optic nerve sheath diameter was assessed using ultrasonography in 50 patients treated in the neurocritical care unit, and the obtained findings were compared with brain computed tomography (CT) data. The study included patients aged 35–70 years. Of the 50 patients, 33 (66%) were male and 17 (34%) were female. The obtained clinical and instrumental data indicate that ultrasonographic assessment of the optic nerve sheath diameter may be useful for rapid bedside screening and dynamic monitoring of patients with suspected cerebral edema and intracranial hypertension, as well as a complementary method to CT examination.
References
[1] A. V. Oshorov, G. V. Danilov, N. E. Zakharova, and A. A. Potapov, Intracranial Pressure, Autoregulation, and Mapping of Cerebral Blood Flow in Severe Trauma. Moscow, Russia, 2018.
[2] A. V. Oshorov, I. A. Savin, and A. S. Goryachev, Intracranial Hypertension. Moscow, Russia, 2021.
[3] V. I. Gorbachev and N. V. Likholetova, “Methods of non-invasive monitoring of intracranial pressure,” S. S. Korsakov Journal of Neurology and Psychiatry, vol. 114, no. 7, pp. 61–66, 2014.
[4] J. Dubourg, E. Javouhey, T. Geeraerts, M. Messerer, and B. Kassai, “Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: A systematic review and meta-analysis,” Intensive Care Medicine, vol. 37, pp. 1059–1068, 2011, doi: 10.1007/s00134-011-2224-2.
[5] C. Robba et al., “Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: A systematic review and meta-analysis,” Intensive Care Medicine, vol. 44, pp. 1284–1294, 2018, doi: 10.1007/s00134-018-5305-7.
[6] C. Robba et al., “Optic nerve sheath diameter ultrasonography at admission as a predictor of intracranial hypertension in traumatic brain injured patients: A prospective observational study,” Journal of Neurosurgery, vol. 132, no. 4, pp. 1279–1285, 2020, doi: 10.3171/2018.11.JNS182077.
[7] R. Moretti and B. Pizzi, “Ultrasonography of the optic nerve in neurocritically ill patients,” Acta Anaesthesiologica Scandinavica, vol. 55, pp. 644–652, 2011, doi: 10.1111/j.1399-6576.2011.02432.x.
[8] M. H. Aletreby et al., “Optic nerve sheath diameter ultrasound for raised intracranial pressure: A literature review and meta-analysis of its diagnostic accuracy,” Journal of Ultrasound in Medicine, 2021, doi: 10.1002/jum.15732.
[9] S. H. Lee et al., “Ultrasonographic optic nerve sheath diameter to detect increased intracranial pressure in adults: A meta-analysis,” Acta Radiologica, 2019.
[10] C. Robba et al., “Optic nerve sheath diameter: Present and future perspectives for neurologists and critical care physicians,” Neurological Sciences, 2019, doi: 10.1007/s10072-019-04015-x.
[11] N. Chen et al., “Diagnostic accuracy of optic nerve sheath diameter on ultrasound for the detection of increased intracranial pressure in patients with traumatic brain injury: A systematic review and meta-analysis,” 2023.
[12] X. Xu and Q. Zhu, “Optic nerve sheath diameter measured by ultrasonography versus magnetic resonance imaging for diagnosing increased intracranial pressure: A systematic review and meta-analysis,” Medical Ultrasonography, 2023, doi: 10.11152/mu-4037.
[13] “The role of optic nerve sheath ultrasonography in increased intracranial pressure: A systematic review and meta-analysis,” 2023.
[14] “Mean value of B-mode optic nerve sheath diameter as an indicator of increased intracranial pressure: A systematic review and meta-analysis,” 2021.
[15] “Optic nerve sheath diameter sonography for the diagnosis of increased intracranial pressure in nontraumatic neurocritically ill patients: A diagnostic accuracy systematic review and meta-analysis,” Neurocritical Care, 2025, doi: 10.1007/s12028-025-02249-6.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 D.B.Atamirzayev, I.I.Otaboyev, A.M.Bokiyev, Sh.Sh.Solijanov, A.Sh.Abdurazzakov, A.H.Valijanov

This work is licensed under a Creative Commons Attribution 4.0 International License.
