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Pediatric Critical Care Medicine:
doi: 10.1097/01.pcc.0000449023.67001.61
Abstracts of the 7th World Congress on Pediatric Critical Care

ABSTRACT 297: SONOGRAPHIC EVALUATION OF OPTIC NERVE SHEATH DIAMETER (ONSD) IN CHILDREN WITH RAISED INTRACRANIAL PRESSURE (RICP): PRELIMINARY RESULTS

Bouguetof, H.1; Elhalimi, K.1; Negadi, M.A.1; Boumendil, D.1; Mentouri, Z.1

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1pediatric intensive care, Faculty of Medicine – Oran University-Laboratory of Pediatric Accidentology, Oran, Algeria

Background and aims: The optic nerve is part of the central nervous system, and a RICP can directly affect the perioptic nerve space, leading to an increase of nerve diameter. Transorbital sonography is a safe and easy-to-perform method to measure ONSD for rapid diagnosis of increased ICP.

Aims: The hypothesis is that ultrasound measurement of the ONSD can accurately predict the RICP.

Methods: The study was conducted in pediatric intensive care unit of Oran’s Hospital University Center. ONSD was measured by ocular ultrasound, 3 mm behind the retina in the transversal and sagittal plans with a linear probe of 7.5 MHz just before the realization of the ICP monitoring and the means was calculated. Transcranial Doppler velocity measurements in the Middle cerebral artery were made simultaneously. Two groups were examined: G1: normal ICP and G2: RICP.

Results: Twelve children, 6 in each group. The mean ± SD ages were 6.9 ± 5.6 years in the G1 and 6.8 ± 5.5 years in the G2. The mean ONSD were 5.6 ± 0.6 mm (range: 4.55 to 7.6 mm) in the G2 and 3.3 ± 0.6 mm (range: 2 to 4.35 mm) in the G1. The difference in the means was significant at P < .001.

Conclusions: Optic nerve diameter, measured by transorbital sonography, was significantly greater in pediatric patients with increased ICP compared with a control group. Transorbital sonography can be used to identify pediatric patients with raised ICP.

©2014The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

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