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Given the widespread availability and use of computed tomography (CT) in patients with acute brain injury, prior work has attempted to use optic nerve diameter measurements to identify those at risk of intracranial hypertension. We aimed to validate the use of optic nerve diameter measurements on CT as a screening tool for intracranial hypertension in a large cohort of brain-injured patients. We performed a retrospective observational cohort study in a single tertiary referral Neuroscience Intensive Care Unit. We identified patients with documented intracranial pressure (ICP) measures as part of their routine clinical care who had non-contrast CT head scans collected within 24\u2009h, and then measured the optic nerve diameters and explored the relationship and test characteristics of these measures to identify those at risk of intracranial hypertension. In a cohort of 314 patients, optic nerve diameter on CT was linearly but weakly associated with ICP. When used to identify those with intracranial hypertension (&gt; 20\u2009mm Hg), the area under the receiver operator curve (AUROC) was 0.68. Using a previously proposed threshold of 0.6\u2009cm, the sensitivity was 81%, specificity 43%, positive likelihood ratio 1.4, and negative likelihood ratio 0.45. CT-derived optic nerve diameter using a threshold of 0.6\u2009cm is sensitive but not specific for intracranial hypertension, and the overall correlation is weak.<\/jats:p>","DOI":"10.1089\/neu.2023.0051","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T05:59:21Z","timestamp":1684735161000},"page":"2282-2288","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Optic Nerve Diameter on Non-Contrast Computed Tomography and Intracranial Hypertension in Patients With Acute Brain Injury: A Validation Study"],"prefix":"10.1177","volume":"40","author":[{"given":"Joshua","family":"Kahan","sequence":"first","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanley","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Weill Cornell Medicine, New York, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hailan","family":"Elnaas","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judy H.","family":"Ch'ang","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santosh B.","family":"Murthy","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander E.","family":"Merkler","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mert R.","family":"Sabuncu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Weill Cornell Medicine, New York, New York, USA."},{"name":"School of Electrical and Computer Engineering, Cornell University and Cornell Tech, New York, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Radiology, Weill Cornell Medicine, New York, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hooman","family":"Kamel","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199302000-00006"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.85.3.0419"},{"issue":"4","key":"e_1_3_5_4_2","article-title":"Hemorrhagic complications of external ventricular drainage","volume":"59","author":"Maniker AH","year":"2006","unstructured":"Maniker AH, , Vaynman AY, , Karimi RJ, et al. 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