{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T20:22:32Z","timestamp":1778703752334,"version":"3.51.4"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Prompt and accurate detection of elevated intracranial pressure (ICP) is vital in the management of pediatric traumatic brain injury (TBI). While invasive ICP monitoring remains the gold standard, its application is often limited by contraindications or local logistical constraints. Consequently, a substantial number of moderate TBI cases are managed without direct ICP monitoring, despite the risk of secondary intracranial hypertension. This underscores the need for reliable, non-invasive diagnostic alternatives. One such technique\u2014optic nerve sheath diameter (ONSD) measurement via point-of-care ultrasound (POCUS)\u2014leverages cerebrospinal fluid (CSF) accumulation around the retrobulbar optic nerve as a surrogate marker for raised ICP. Although ONSD is recognised for its simplicity, speed, and repeatability, its clinical adoption in pediatric settings remains limited due to the absence of standardised guidelines and normative data. This manuscript synthesises the current evidence on ONSD measurement in children, highlighting its diagnostic potential, methodological considerations, and limitations. By consolidating recent research, we aim to support pediatric intensivists in the practical application of ONSD as a non-invasive tool for ICP assessment, ultimately improving clinical decision-making and prognostic evaluation in pediatric TBI.<\/jats:p>","DOI":"10.3389\/fped.2025.1741048","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:53:59Z","timestamp":1769064839000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Measuring optic nerve sheath diameter in children: a simple ultrasound protocol for ICP assessment"],"prefix":"10.3389","volume":"13","author":[{"given":"Bogdana Sabina","family":"Zoica","sequence":"first","affiliation":[{"name":"Pediatric Intensive Care Unit, King\u2019s College Hospital","place":["London, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bipin","family":"Chalattil","sequence":"additional","affiliation":[{"name":"Intensive Care, Great Ormond Street Hospital for Children","place":["London, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/S1474-4422(17)30118-7","article-title":"Severe traumatic brain injury: targeted management in the intensive care unit","volume":"16","author":"Stocchetti","year":"2017","journal-title":"Lancet Neurol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1097\/CCM.0000000000006345","article-title":"Optic nerve sheath diameter point-of- care ultrasonography quality criteria checklist: an international consensus statement on optic nerve sheath diameter imaging and measurement","volume":"52","author":"Hirzallah","year":"2024","journal-title":"Crit Care Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1055\/s-0039-1692863","article-title":"Multimodal neuromonitoring: current scenario in neurocritical care","volume":"6","author":"Goyal","year":"2019","journal-title":"J Neuroanaesthesiol Crit Care"},{"key":"B4","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.bj.2020.04.006","article-title":"Point-of-care ultrasound of optic nerve sheath diameter to detect intracranial pressure in neurocritically ill children\u2014a narrative review","volume":"43","author":"Lin","year":"2020","journal-title":"Biomed J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"950393","DOI":"10.1155\/2012\/950393","article-title":"Intracranial pressure monitoring: invasive versus noninvasive methods-a review","volume":"2012","author":"Raboel","year":"2012","journal-title":"Crit. 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