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Abstract

Medicine

Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition

Published: August 18th, 2023

DOI:

10.3791/64929

1Department of Surgery, Duke University School of Medicine, 2Medical Computing Group, Kitware Incorporated, 3Division of Neurocritical Care, Duke University School of Medicine, 4Department of Neurology, Duke University School of Medicine, 5Department of Anesthesiology, Duke University School of Medicine

Abstract

The goal of this protocol is to develop a standardized method for acquiring images of the optic nerve sheath and measuring the optic nerve sheath diameter (ONSD). Diagnostic ultrasound of the ONSD to detect intracranial hypertension has traditionally faced many problems because of methodologic discrepancies. Due to inconsistencies in the measuring techniques, the potential for ONSD to become a non-invasive bedside monitoring tool for ICP has been hampered. However, establishing a transparent, consistent methodology for measuring the ONSD would support its use as a valid and reliable method of identifying intracranial hypertension. This is important as it has both high sensitivity and specificity in acute care settings. This narrative review describes ONSD POCUS image acquisition, including patient positioning, transducer selection, probe placement, the acquisition sequence, and image optimization. Further, visual aids are provided to assist in real-time during image acquisition. This method should be considered for patients for whom there are concerns regarding intracranial hypertension but who do not have an intracranial monitor in place.

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Keywords Optic Nerve Sheath

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