{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T01:29:03Z","timestamp":1783646943599,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T00:00:00Z","timestamp":1664928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>Optic nerve sheath diameter (ONSD) is a promising metric to estimate intracranial pressure (ICP). There is no consensus whether ONSD should be measured external (ONSDext) or internal (ONSDint) of the dura mater. Expert opinion favors ONSDint, though without clear evidence to support this. Adjustments of ONSD for eye diameter (ED) and optic nerve diameter (OND) have been suggested to improve precision. We examined the diagnostic accuracy of ONSDext and ONSDint for estimating ICP, unadjusted as well as adjusted for ED and OND.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed an observational cohort study, measuring ONSDext and ONSDint in patients with invasive ICP monitoring at Karolinska University Hospital in Stockholm, Sweden. We used ONSDext and ONSDint unadjusted as well as adjusted for ED and for OND. We compared the area under the receiver operator characteristics curve (AUROC) for these methods. Thresholds for elevated ICP were set at \u226520 and \u226522\u00a0mmHg, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 220 measurements from 100 patients. Median ONSDext and ONSDint were significantly different at 6.7 and 5.2\u00a0mm (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.00). There was no significant difference in AUROC for predicting elevated ICP between ONSDext and ONSDint (.67\u00a0vs. .64, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.31). Adjustment for ED yielded better diagnostic accuracy (AUROC, cutoff, sensitivity, specificity) for ONSDext\/ED (.76, .29, .81, .62) and ONSDint\/ED (.71, .24, .5, .89).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ONSDext and ONSDint differ significantly and are not interchangeable. However, there were no significant differences in diagnostic accuracy between ONSDext and ONSDint. Adjustment for ED may improve diagnostic accuracy of ONSD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jon.13062","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T14:24:08Z","timestamp":1664979848000},"page":"58-66","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Optic nerve sheath diameter in intracranial hypertension: Measurement external or internal of the dura mater?"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6665-0589","authenticated-orcid":false,"given":"Jakob","family":"Pansell","sequence":"first","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Anesthesia and Intensive Care Medicine Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Medicine Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Physiology &amp; Pharmacology Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rudberg","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Medicine Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Physiology &amp; Pharmacology Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Friman","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Medicine Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charith","family":"Cooray","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Clinical Neurophysiology Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,5]]},"reference":[{"issue":"2","key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1007\/s12028-014-0041-5","article-title":"Consensus summary statement of the international multidisciplinary consensus conference on multimodality monitoring in neurocritical care: a statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine","volume":"21","author":"Le Roux P","year":"2014","journal-title":"Neurocrit Care"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000001432"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2018.6086"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3171\/2017.8.FOCUS17450"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v7.i13.1535"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2020.7266"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15732"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12906"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12233"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3171\/2021.1.JNS204218"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12936"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-019-00762-z"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2020.01.008"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-019-00853-x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-16173-z"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1971400918789385"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/njcp.njcp_119_17"}],"container-title":["Journal of Neuroimaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jon.13062","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jon.13062","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jon.13062","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T22:48:08Z","timestamp":1692571688000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jon.13062"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,5]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1111\/jon.13062"],"URL":"https:\/\/doi.org\/10.1111\/jon.13062","archive":["Portico"],"relation":{},"ISSN":["1051-2284","1552-6569"],"issn-type":[{"value":"1051-2284","type":"print"},{"value":"1552-6569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,5]]},"assertion":[{"value":"2022-06-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}