{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:04:43Z","timestamp":1779689083467,"version":"3.53.1"},"reference-count":31,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Elevated intracranial pressure (ICP) is a major determinant of secondary injury and mortality in severe traumatic brain injury (TBI), yet objective markers of decompressive craniectomy (DC) efficacy remain limited. Optic nerve sheath diameter (ONSD), measurable on computed tomography (CT), has emerged as a non-invasive surrogate of ICP. This study evaluated the relationship between perioperative ONSD changes and clinical and surgical parameters in patients undergoing DC. In this retrospective cohort study, 72 patients with severe TBI were included. ONSD was measured on preoperative and early postoperative CT, and the change (\u0394ONSD) was analyzed in relation to craniectomy surface area and outcomes. DC resulted in a significant reduction in ONSD (6.44 \u00b1 0.88 mm vs. 5.55 \u00b1 0.82 mm, p &lt; 0.001). Larger craniectomy surface areas were associated with greater \u0394ONSD change (r = \u22120.31, p = 0.008). \u0394ONSD was independently associated with in-hospital mortality (OR = 0.12, p = 0.005), with larger reductions associated with improved survival. Additionally, \u0394ONSD was correlated with shorter hospital stay (\u03c1 = \u22120.32, p = 0.007). These findings support \u0394ONSD as a practical imaging biomarker reflecting the physiological response to DC in severe TBI.<\/jats:p>","DOI":"10.3390\/life16050817","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T05:33:54Z","timestamp":1779687234000},"page":"817","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic Changes in Optic Nerve Sheath Diameter on Computed Tomography Predict Decompressive Efficacy and Outcomes in Severe Traumatic Brain Injury"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1126-0078","authenticated-orcid":false,"given":"Nicoleta-Larisa","family":"Serban","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Cluj County Clinical Emergency Hospital, 400347 Cluj-Napoca, Romania"},{"name":"Department of Neurosciences, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7127-0946","authenticated-orcid":false,"given":"Ioan-Stefan","family":"Florian","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cluj County Clinical Emergency Hospital, 400347 Cluj-Napoca, Romania"},{"name":"Department of Neurosciences, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4811-2744","authenticated-orcid":false,"given":"Teodora Maria","family":"Bodog","sequence":"additional","affiliation":[{"name":"Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Anaesthesia and Intensive Care, County Emergency Hospital Bihor, 410167 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matei-Ioan","family":"Baltac","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cluj County Clinical Emergency Hospital, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6835-2285","authenticated-orcid":false,"given":"Alexandra Cristiana","family":"Gache","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Faculty of Medicine, Campus\u2014Corp B, Ovidius University of Constanta, 1 University Alley, 900470 Constanta, Romania"},{"name":"Clinical Hospital of Pneumopthisiology Constanta, 40 Santinelei Street, 900002 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Ionescu","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Department of Anesthesiology and Intensive Care, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Outcome Research Consortium, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/S1474-4422(17)30371-X","article-title":"Traumatic Brain Injury: Integrated Approaches to Improve Prevention, Clinical Care, and Research","volume":"16","author":"Maas","year":"2017","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jcrc.2020.01.006","article-title":"Optic Nerve Sheath Diameter Measurement for Predicting Raised Intracranial Pressure in Adult Patients with Severe Traumatic Brain Injury: A Meta-Analysis","volume":"56","author":"Lee","year":"2020","journal-title":"J. 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