{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:58:17Z","timestamp":1790319497456,"version":"4.1.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n Measuring optic nerve sheath diameter (ONSD) by transbulbar ultrasonography (TBUS) can suffice non-invasive ICP measurement with considerable accuracy.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n The primary objective of this study was to evaluate the perioperative variation in ONSD by TBUS in Traumatic Brain Injury (TBI) patients undergoing emergency craniectomy.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We prospectively compared bilateral ONSD measurements in 45 consecutive TBI cases undergoing decompressive craniectomy under general anesthesia; before and after surgery. A total of 180 ONSD images were obtained and measurements were done by the same investigator blinded to the pre\/postoperative nature of the image.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Based on preoperative Glasgow Coma Scores, 34 cases (75.5%) had severe TBI; 10 cases (22.2%) moderate TBI; and 1 case (2.2%) mild TBI. Preoperative ONSD in the study population were as 6.625 \u00b1 0.414mm. Average ONSD reduced significantly by 0.249 \u00b1 0.148 mm (\n P<\/jats:italic>\n < 0.001) after craniectomy. On pooled analysis of cases undergoing right versus left sided craniectomy average ONSD reduced significantly by 0.252 \u00b1 0.173 mm (\n P<\/jats:italic>\n < 0.001) and 0.259 \u00b1 0.139 mm (\n P<\/jats:italic>\n < 0.001), respectively. ONSD of right eye with left eye and vice-versa were strongly correlated both pre\/postoperatively with Pearson correlation coefficients (r)=0.879 (\n P<\/jats:italic>\n < 0.001) and r = 0.827 (\n P<\/jats:italic>\n < 0.001), respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n In TBI cases undergoing decompressive craniectomy ONSD is bilaterally increased preoperatively. ONSD reduces significantly immediately after craniectomy; however, the diameters did not near the normal range. There hold a strong correlation between right\/left ONSD measurements irrespective of the laterality of injury or side of surgery. Variable elastic properties of ONS in an injured brain can possibly explain our findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/0028-3886.355178","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:36:16Z","timestamp":1664152576000},"page":"1460-1467","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Perioperative Variation in Optic Nerve Sheath Diameter \u2013 A Prospective Observational Study of Traumatic Brain Injury Patients Undergoing Decompressive Craniectomy"],"prefix":"10.4103","volume":"70","author":[{"given":"Varun","family":"Suresh","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Government Medical College, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P R","family":"Ushakumari","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Government Medical College, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anurag","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Neuroanesthesia and Pain Medicine, Fortis Hospital, Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Government Medical College, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja K","family":"Kutty","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Government Medical College, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajmohan B","family":"Prabhakar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Government Medical College, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anilkumar","family":"Peethambaran","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Government Medical College, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,8,30]]},"reference":[{"key":"R1-20250921","first-page":"1","article-title":"Estimating the global incidence of traumatic brain injury","author":"Dewan","year":"2018","journal-title":"J Neurosurg"},{"key":"R2-20250921","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S1474-4422(18)30415-0","article-title":"Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016","volume":"18","year":"2019","journal-title":"Lancet 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