Ultrasound Evaluation of the Optic Nerve Sheath as a Predictor of Severity and Complications

Abstract

Objectives: Ultrasonography has the potential advantage of being a repeatable tool, safe at the bedside and low cost, without risks of radiation and side effects. Emerging as a tool with potential to promote the optimization of the prognosis of neurosurgical patients.

Methods: 31 participants diagnosed with expansive brain injury were selected, all over 18 years of age, after signing the free consent form and clarification,the postoperative evaluation was carried out at the time of hospital discharge and 3 months after surgery on an outpatient basis. The ultrasound evaluation of the optic nerve sheaths was performed by a team member, who was blind to the clinical and radiological information and using the same GE VERSANA ACTIVE ultrasound device.

Results: During the preoperative analysis of 31 patients, 41.9% were male (n=13) and 58.06% female (n=16), with a mean age of 50.64 +- 16.29. Regarding the functional analysis with KPS, it was found that 58% of patients (regardless of sex) had results >=70, equivalent to 18 patients. Regarding the diameter of the optic nerve sheath performed by ultrasound, the value of the preoperative BOD was greater than 6.1 mm, the value greater than 6.2 mm determined unfavorable prognosis in 3 months.

Discussion: In the present study, the cutoff point of the BNO measurement for favorable or unfavorable prognosis was 6.1 mm, and when we correlated this variable with the analyzed KPS variable, we can observe that they correlate, mainly with outcome, getting an unfavorable result.