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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(02): 242-249
DOI: 10.1055/s-0044-1786701
Research Article

Comparison of Optic Nerve Sheath Diameter (ONSD) Measurements Obtained from USG Before and After Placement of Ventriculoperitoneal Shunt in Obstructive Hydrocephalus as a Surrogate Marker for Adequacy of Shunt Function: A Prospective Observational Study

Autor*innen

  • M. S. Mohamed Salih

    1   Department of Neuroanesthesiology, All India Institute of Medical Sciences, New Delhi, India

  • Adinarayanan Sethuramachandran

    2   Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

  • Prasanna Udupi Bidkar 

    2   Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

  • Ankita Dey 

    3   Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Bathinda, Bathinda, Punjab, India

  • Gopikrishnan R.

    4   Department of Neurosurgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

  • Adethen Gunasekaran

    2   Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

  • Vivek Chandar

    2   Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Abstract

Introduction Optic nerve sheath diameter (ONSD) measured using ultrasonography has been widely used as a surrogate marker of elevated intracranial pressure. However, literature is sparse on the correlation between ONSD and ventriculoperitoneal (VP) shunt function, especially in adults with hydrocephalus. Our study was designed to assess the correlation between ONSD measured using ultrasonography before and 12 hours after VP shunt placement and the success of VP shunt placement assessed using computed tomography (CT) of the brain.

Materials and Methods Fifty-one patients between 16 and 60 years of age, with obstructive hydrocephalus scheduled for VP shunt surgery were included in this prospective, observational study. ONSD measurements were obtained from both eyes prior to induction of anesthesia, immediately after the surgery, and at 6, 12, and 24 hours after the surgery. An average of three readings was obtained from each eye. Cerebrospinal fluid (CSF) opening pressure was noted after entry into the lateral ventricle. Noncontrast CT (NCCT) brain was obtained 12 hours after the surgery and was interpreted by the same neurosurgeon for signs of successful VP shunt placement.

Results There was a significant reduction in ONSD in the postoperative period compared to ONSD measured preoperatively. The average ONSD (mean ± standard deviation) measured prior to induction of anesthesia, immediately after the surgery, and at 6, 12, and 24 hours after the surgery was 5.71 ± 0.95, 5.20 ± 0.84, 5.06 ± 0.79, 4.90 ± 0.79, and 4.76 ± 0.75 mm, respectively. The mean CSF opening pressure was 19.6 ± 6.9 mm Hg. Postoperative NCCT brain revealed misplacement of the shunt tip in only one patient.

Conclusion ONSD measured using ultrasonography may be used as a reliable indicator of VP shunt function in adults with obstructive hydrocephalus.

Keywords

computed tomography scan - hydrocephalus - optic nerve - ultrasonography - ventriculoperitoneal shunt

Authors' Contributions

The concept and design of the review article were developed by P.U.B., A.D., A.S., and S.M. Data acquisition, analysis, and manuscript preparation were carried out by P.U.B., A.G., V.C., and S.M. Critical revision and finalization of the manuscript were conducted by P.U.B., A.D., and A.S.. All authors contributed to the conceptualization and design of the review article. Additionally, all authors have thoroughly reviewed and approved the manuscript, attesting to its integrity and authenticity.




Publikationsverlauf

Artikel online veröffentlicht:
03. Juni 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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