Ultrasonography of the optic nerve sheath: usefulness in the non-invasive evaluation of intracranial hypertension
DOI:
https://doi.org/10.70577/qcnp9315Keywords:
intracranial hypertension; optic nerve sheath diameter; ultrasonography; intracranial pressure; non-invasive neuromonitoring; neurocritical care.Abstract
Introduction: The recognition of intracranial hypertension represents an important framework for the management of a critical neurological condition, often associated with clinical deterioration and the risk of secondary brain injury. Ultrasonographic measurement of the optic nerve sheath diameter (ONSD) is a non-invasive, rapid, and reproducible tool for estimating changes related to intracranial pressure, with particular importance in contexts where invasive monitoring or neuroimaging may not be immediately available.
Objective: To evaluate the usefulness of ultrasonographic ONSD measurement as an alternative method for detecting, monitoring, and clinically assessing intracranial hypertension.
Methodology: A structured narrative review of scientific articles on ONSD and intracranial hypertension was conducted, including observational studies, cohort studies, reviews, case reports, and studies in adult, pediatric, neurocritical, and healthy populations. Methodological characteristics, study population, measurement technique, cutoff points, correlation with intracranial pressure, neuroimaging, clinical evolution, and reported limitations were analyzed.
Results: The reviewed evidence shows that ONSD is most useful when compared with invasive intracranial pressure monitoring, neuroimaging findings, or dynamic changes following therapeutic interventions. Its performance was relevant in neurocritical patients, traumatic brain injury, pediatric hydrocephalus, and stroke. In metabolic or systemic scenarios, such as hyponatremia and hepatic encephalopathy, it reflected possible changes related to cerebral edema, although with less consistent prognostic value.
Conclusions: ONSD constitutes a useful complementary tool within non-invasive neuromonitoring; however, it requires technical standardization, operator training, and population-specific cutoff points.
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Copyright (c) 2026 Jimmy Fernando Yaguana Torres,Jimmy Fabricio Achi Arteaga, Emily Valeria López Fajardo, Joselin Nicol Gutiérrez Abril, Luis Enrique Ushca Martínez (Autor/a)
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