Ultrasonographic measurement of the optic nerve as an indicator of intracranial hypertension in neurotrauma: a systematic review.

Abstract

A systematic review was conducted to evaluate the diagnostic accuracy of ultrasound measurement of the optic nerve sheath diameter (ONSD) as a non-invasive tool for estimating intracranial pressure (ICP) in patients with traumatic brain injury (TBI). The PubMed and ScienceDirect databases were searched using the keywords "optic nerve sheath diameter," "ultrasound," "intracranial pressure," "traumatic brain injury," and "neurotrauma." Original studies in English and Spanish that analyzed the relationship between ONSD and increased ICP were included, while duplicate articles, narrative reviews, and studies without applicable clinical data were excluded. The results showed a significant correlation between increased ONSD and elevated ICP, with sensitivities above 85% and specificities near or above 90%. However, the heterogeneity in threshold values, differences in measurement techniques, and the lack of randomized controlled trials limit the generalizability of the findings. Most studies were observational, introducing inherent methodological biases. It is recommended that future research be prospective, multicenter, and controlled to more rigorously assess the diagnostic accuracy of ONSD ultrasound in detecting increased ICP in TBI patients.