{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:11:06Z","timestamp":1790611866248,"version":"4.1.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"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:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intracranial hypertension (IH) is a potentially life-threatening condition in pediatric patients that requires early recognition. Ultrasonographic measurement of optic nerve sheath diameter (ONSD) has emerged as a promising non-invasive surrogate for intracranial pressure (ICP), although pediatric data remain limited and diagnostic thresholds are not well established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the correlation between ONSD and directly measured ICP, and to determine an optimal ONSD cutoff for detecting intracranial hypertension in pediatric patients with closed fontanelles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational pilot study included pediatric patients admitted to a tertiary care center who required lumbar puncture with ICP measurement. ONSD was measured using transocular ultrasound immediately prior to lumbar puncture, at 3\u2005mm posterior to the globe. Mean bilateral ONSD values were used when available. Correlation between ONSD and ICP was assessed using Spearman's rho. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff for detecting intracranial hypertension (defined as ICP &amp;gt;27\u2005cmH\u2082O).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen patients were included, yielding 15 paired ONSD\u2013ICP measurements. Median ONSD was 6.20\u2005mm (IQR 5.68\u20136.53), and median ICP was 34\u2005cmH\u2082O (IQR 26\u201344). A significant positive correlation was observed between ONSD and ICP (Spearman's rho\u2009=\u20090.65,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). ROC analysis identified an optimal ONSD cutoff of 6.1\u2005mm, with a sensitivity of 80% and specificity of 80% (AUC 0.88). Agreement between ONSD and ICP classification was moderate (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.57).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ONSD ultrasonography appears to be a feasible and promising non-invasive method for detecting intracranial hypertension in pediatric patients with closed fontanelles. An ONSD threshold of 6.1\u2005mm may help identify elevated ICP, although larger multicenter studies are required to validate these findings<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1785962","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:06:29Z","timestamp":1777442789000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Ultrasonographic optic nerve sheath diameter as a non-invasive marker of intracranial hypertension in pediatric patients: a pilot study"],"prefix":"10.3389","volume":"14","author":[{"given":"Ra\u00fal","family":"Montero-Y\u00e9boles","sequence":"first","affiliation":[{"name":"1Pediatric Intensive Care Unit, Reina Sof\u00eda Universitary Hospital","place":["C\u00f3rdoba, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Ferrin-Di\u00e1nez","sequence":"additional","affiliation":[{"name":"1Pediatric Intensive Care Unit, Reina Sof\u00eda Universitary Hospital","place":["C\u00f3rdoba, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Rosell\u00f3","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Clinico Universitary Hospital","place":["Valencia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis","family":"L\u00f3pez-Prats","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Clinico Universitary Hospital","place":["Valencia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Ruiz-S\u00e1ez","sequence":"additional","affiliation":[{"name":"1Pediatric Intensive Care Unit, Reina Sof\u00eda Universitary Hospital","place":["C\u00f3rdoba, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Ramon y Cajal Universitary Hospital","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"B1","volume-title":"Observations on the Structure and Functions of the Nervous System","author":"Monro","year":"1783"},{"key":"B2","first-page":"84","article-title":"An account of the appearances observed in the dissection of two of three individuals presumed to have perished in the storm of the 3d, and whose bodies were discovered in the vicinity of leith on the morning of the 4th, November 1821; with some reflections on the pathology of the brain: part I","volume":"1","author":"Kellie","year":"1824","journal-title":"Trans Med Chir Soc Edinb."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2471","DOI":"10.1056\/NEJMoa1207363","article-title":"A trial of intracranial-pressure monitoring in traumatic brain injury","volume":"367","author":"Chesnut","year":"2012","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1097\/PCC.0000000000000074","article-title":"The risks of intrahospital transport of critically ill children","volume":"15","author":"Taylor","year":"2014","journal-title":"Pediatr Crit Care Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1007\/BF01627610","article-title":"The subarachnoid space surrounding the optic nerves. 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