Original Article Ultrasonic Measurement Of Optic Nerve Sheath Diameter In Elderly Patients With Craniocerebral Injury

Objective: To explore the application value of ultrasonic measurement of optic nerve sheath diameter in elderly patients with craniocerebral injury. Methods: 86 cases of elderly patients with craniocerebral injury treated in our hospital between January 2017 and December 2018 were included, all of whom had the invasive monitoring of intracranial pressure (ICP) and optic nerve sheath diameter (ONSD) in ultrasonic testing. According to ICP measurement results, patients were divided into a normal ICP group (n = 44) and an increased ICP group (ICP >= 20 mmHg stood for increased ICP, n = 42). Gender, age, systolic blood pressure, blood glucose, hospital stay, oxyhemoglobin saturation, ISS score, ONSD value, hematoma type, primary injury, associated injury and complications of the patients were compared. Results: The univariate analysis showed that the systolic blood pressure in the ICP increased group was significantly decreased while the blood glucose, ISS and ONSD values showed significant increase (P < 0.05). The multivariate analysis showed that associated injury, systolic blood pressure and ONSD value had a significant influence on the increase of intracranial pressure (all P < 0.05). ONSD is positively correlated with ICP (r = 0.855, P = 0.000). The areas of systolic blood pressure and ONSD value under the curve in diagnosis of increased intracranial pressure in elderly patients with craniocerebral injury were 0.717 and 0.780, respectively. When the ONSD value was 4.90 mm, the area under the curve was 0.780, the sensitivity and specificity were 89.00% and 91.00%, respectively. When the ONSD value predicted that the critical value of good/poor prognosis of patients was 4.70 mm, the area under the curve was 0.796, the sensitivity was 91.00%, and the specificity was 90.00%. Conclusion: Ultrasound measurement of optic nerve sheath diameter can diagnose the increase of intracranial pressure in elderly patients with craniocerebral injury, and can better predict the prognosis.