Frontiers in neurology · 2026
Dynamic optic nerve sheath diameter monitoring for intracranial pressure assessment in TBI patients.
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Yang Liu, Xie Zhihui, Xiang Jie, Wang Huiting, Jiang Hui
Аннотация
OBJECTIVE: To explore the role of dynamic monitoring of optic nerve sheath diameter (ONSD) in the assessment of intracranial pressure (ICP) in patients with traumatic brain injury (TBI).
METHODS: A prospective study was conducted on patients with traumatic brain injury admitted to the Neurocritical Care Unit of the First People's Hospital of Changde between 01/06/2024 and 30/09/2025. All enrolled patients underwent invasive ICP monitoring. A 14-5 MHz ultrasound probe was used to measure the ONSD in both eyes, with ICP values recorded simultaneously during ONSD measurements. Data were collected both before and 20 min after mannitol infusion administration. The Wilcoxon signed-rank test was used to compare ONSD and ICP before and after mannitol infusion, and Spearman correlation analysis was performed to assess their relationship.
RESULTS: A total of 71 TBI patients were enrolled in this study, including 37 males and 34 females, with a mean age of 57.1 ± 14.0 years. After mannitol infusion, ONSD significantly decreased from 6.39 (6.13, 6.73) mm to 4.94 (4.71, 5.61) mm (p = 0.021). Concurrently, ICP decreased from 35 (32, 41) mmHg to 21 (17, 28) mmHg, with a statistically significant difference (p = 0.010). Both ICP and ONSD were significantly lower after mannitol infusion compared to before infusion (p < 0.05). Moreover, a significant correlation was observed between ICP and ONSD both before and after infusion (Spearman's ρ = 0.860, p < 0.01).
CONCLUSION: Dynamic monitoring of ONSD can reflect changes in intracranial pressure in patients with TBI, demonstrating potential utility in the assessment of intracranial hypertension.
METHODS: A prospective study was conducted on patients with traumatic brain injury admitted to the Neurocritical Care Unit of the First People's Hospital of Changde between 01/06/2024 and 30/09/2025. All enrolled patients underwent invasive ICP monitoring. A 14-5 MHz ultrasound probe was used to measure the ONSD in both eyes, with ICP values recorded simultaneously during ONSD measurements. Data were collected both before and 20 min after mannitol infusion administration. The Wilcoxon signed-rank test was used to compare ONSD and ICP before and after mannitol infusion, and Spearman correlation analysis was performed to assess their relationship.
RESULTS: A total of 71 TBI patients were enrolled in this study, including 37 males and 34 females, with a mean age of 57.1 ± 14.0 years. After mannitol infusion, ONSD significantly decreased from 6.39 (6.13, 6.73) mm to 4.94 (4.71, 5.61) mm (p = 0.021). Concurrently, ICP decreased from 35 (32, 41) mmHg to 21 (17, 28) mmHg, with a statistically significant difference (p = 0.010). Both ICP and ONSD were significantly lower after mannitol infusion compared to before infusion (p < 0.05). Moreover, a significant correlation was observed between ICP and ONSD both before and after infusion (Spearman's ρ = 0.860, p < 0.01).
CONCLUSION: Dynamic monitoring of ONSD can reflect changes in intracranial pressure in patients with TBI, demonstrating potential utility in the assessment of intracranial hypertension.