Document Detail

Optic nerve sheath diameter and lumbar puncture opening pressure in nontrauma patients suspected of elevated intracranial pressure.
MedLine Citation:
PMID:  25284485     Owner:  NLM     Status:  Publisher    
OBJECTIVE: The purpose of this study was to determine if patients with nontraumatic causes of elevated intracranial pressure (ICP) could be identified by ultrasound measurement of optic nerve sheath diameter (ONSD). It was hypothesized that an ONSD greater than or equal to 5 mm would identify patients with elevated ICP.
METHOD: This was a prospective observational trial comparing ONSD with ICP measured by opening pressure manometry on lumbar puncture (LP). The cohort consisted of a convenience sample of adult patients presenting to the emergency department, requiring LP. The ONSD measurement was performed before computed tomography and LP. The physician performing the LP was blinded to the result of the ONSD measurement. An opening pressure on manometry of greater than or equal to 20 cm H2O and an ONSD greater than or equal to 5 mm were considered elevated.
RESULTS: Fifty-one patients were included in our study, 24 (47%) with ICP greater than or equal to 20 cm H2O and 27 (53%) with ICP less than 20 cm H2O. The sensitivity of ONSD greater than or equal to 5 for identifying elevated ICP was 75% (95% confidence interval, 53%-90%) with specificity of 44% (25%-65%). The area under the receiver operator characteristic curve was 0.69 (0.54-0.84), suggesting a relationship between ONSD and ICP.
CONCLUSION: An ONSD greater than or equal to 5 mm was associated with elevated ICP in nontraumatic causes of elevated ICP. Although a relationship exists, a sensitivity of 75% does not make ONSD measurement an adequate screening examination for elevated ICP in this patient population.
Terrell S Caffery; J Nelson Perret; Mandi W Musso; Glenn N Jones
Related Documents :
11846705 - Ambulatory blood pressure as predictor of preeclampsia in diabetic pregnancies with res...
1727815 - Markers of sodium and volume homeostasis in pregnancy-induced hypertension.
1549265 - Blood pressure in a random sample of the new zealand population.
9204695 - Psychosocial factors in blood pressure variation: a comparative study of young samoans.
17385555 - Echocardiographic characterisation of cardiac dilatation induced by volume overload in ...
23863805 - Effect of the angiotensin ii receptor antagonist olmesartan on morning home blood press...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-18
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  -     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-10-6     Completed Date:  -     Revised Date:  2014-10-7    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Inc.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  National specialty trends in billable diagnostic ultrasound in the Emergency Department setting: ana...
Next Document:  Metabolite changes during the life history of Porphyra haitanensis.