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Optic Nerve Sheath Ultrasound for Detecting Increased Intracranial Pressure (ICP)

In podcast 78 on the management of elevated ICP, I discussed ocular nerve sheath ultrasound. Here are some additional resources.

Literature

  • Crit Care 2008;12:150
  • Acad Emeg Med 2003, Vol. 10, No. 4
  • Tayal VS Ann Emerg Med 2006
  • Emerg Med J 2007;24:251
  • Annals of Emergency Medicine 2007;49(4):508-514
  • Inten Care Med 2007;33:1704
  • Academic Emergency Medicine 2008;15 (2) , 201-204
  • Inten Care Med 2008;34:2062
  • Neurocritical Care Dec 2009
  • emerg med j 2011;28:679
  • J Trauma 2011;71:779)
  • Neurocrit Care 2011;15:506
  • Review Article (Acta Anaesthesiol Scand 2011;55:644)

Blogposts

From Life in the Fast Lane

 

Media

From Ultrasound Podcast guys, a 1-minute tutorial

Link to Full Ultrasound Podcast on Ocular Nerve Sheath Exam

 

7 Comments

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Comments

  1. Karim says:
    July 24, 2012 at 18:53

    Hi, I’m wondering why the ETCO2 may not match the PaCO2 in a head injury patient (who is not in shock or has any underlying cardiovascular disease). Thanks!

    Reply
    • emcrit says:
      July 24, 2012 at 19:35

      If they had none of those things, and no atelectasis, and no other trauma it would probably correlate fairly well–at first. Most TBI patients are not that isolated. One correlated set- of-samples doesn’t tell you that their lungs have not started to get bad later on. The TBI state leads to ALI and ARDS on its own without any coexisting external lung injury.

      Reply
  2. Don Diakow says:
    August 14, 2012 at 20:39

    This just wants me to have a Pocket ultrasound machine when I’m on calls. Besides that this is excellent stuff thanks Ultrasound guys!

    Reply
  3. A says:
    September 22, 2012 at 14:26

    I used this technique just last week to confirm an elevated ICP reading by a Codman. I didn’t have a Tegaderm handy, so I just cut a latex glove into sort of a square sheet which I draped over the patient’s closed eye, and then applied ultrasound gel over the latex, leaving the eye completely residue free. Perfect images. Great podcast!

    Reply

Trackbacks

  1. News Klinische Notfall- und Akutmedizin: Ultrasound in EM - intrakranielle Drucksteigerung says:
    August 28, 2012 at 15:43

    [...] geschrieben habe, sehe ich, dass Scott W. auch über dieses Thema einen Blog zusammengestellt hat. Schauen Sie doch hier noch rein. Eingestellt von Prof. Dr. Michael Christ um 08:00 Diesen Post per [...]

    Reply

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