Busaraben Gandhi¹, Stuti Juneja², Manoj Soman^3,4* and Unnikrishnan Nair^3,4

¹Medical Retina Research Fellow, London Northwest University Hospital and Research Institute, London, United Kingdom
²Associate Professor and In-Charge, Head of the Department of Ophthalmology, Medical College Vadodara, Vadodara, Gujarat, India
³Vitreoretinal Services, Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India
⁴Chaithanya Innovation in Technology and Eyecare (Research), Trivandrum, Kerala, India

*Corresponding Author: Manoj Soman, Vitreoretinal Services, Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India.

Received: September 26, 2024; Published: November 20, 2024

Abstract

Objective: To assess the role of optic nerve sheath diameter (ONSD) in predicting mortality, with the goal of reducing overall mortality through early recognition and appropriate interventions.

Design: Prospective study.

Methodology: A study of 180 head injury cases was conducted at a tertiary care hospital over one year to evaluate various ocular manifestations. The Glasgow Coma Scale (GCS) was used to assess head injury severity. Bed side ocular examination and ONSD measurements in primary gaze and in supine position using USG B-scan were obtained. Statistical analysis was done using the chi-square test and descriptive statistics. Ocular neurological signs, ONSD values, and GCS scores were correlated with survival outcomes.

Outcome Measures: In this study of 180 head injury patients, 91.11% had ocular involvement. Most patients were male (88.33%) and between 21-30 years old. Road traffic accidents (81.11%) were the leading cause of injury. Cranial nerve palsies, notably third nerve palsy (2.22%), and pupillary abnormalities (29.44%) were observed. Glasgow Coma Scale (GCS) scores, and optic nerve sheath diameter (ONSD) ≥5mm significantly (P < 0.0001 for each) correlated with mortality.

Conclusions: Ocular manifestations were present in 91.11% of head injury cases. An ONSD ≥5 mm was highly associated with mortality. Increased ONSD could serve as a surrogate bedside measure of prognosis and survival in patients of head injuries.

 Keywords: Glasgow Coma Scale; Head Injury; Optic Nerve Sheath Diameter; Mortality Prediction

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Citation

Citation: Manoj Soman., et al. “The Role of Bedside Optic Nerve Sheath Diameter in Prognosticating Mortality in Head Injury Patients: A Prospective Study”. Acta Scientific Neurology 7.12 (2024): 03-10.

Copyright

Copyright: © 2024 Manoj Soman., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.