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VOLUME 22 , ISSUE 6 ( 2018 ) > List of Articles

CASE REPORT

Keep an Eye on the Intracranial Pressure, Thanks to the Optic Nerve Sheath Diameter

Alexandre Vagh Weinmann, Charlotte Beaucreux, Kevin Kearns, Clément Dubost

Keywords : Brain hemodynamics, cerebral Doppler, cerebral monitoring, coma, optic nerve sheath diameter

Citation Information : Weinmann AV, Beaucreux C, Kearns K, Dubost C. Keep an Eye on the Intracranial Pressure, Thanks to the Optic Nerve Sheath Diameter. Indian J Crit Care Med 2018; 22 (6):460-462.

DOI: 10.4103/ijccm.IJCCM_446_17

License: CC BY-ND 3.0

Published Online: 00-06-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Neurological examination on sedated patients is challenging and no gold standard monitoring is currently available. We report the case of a patient deeply sedated for the management of acute respiratory distress syndrome secondary to pneumonia. Delay in awakening led to cerebral exploration by transcranial Doppler (TCD) and measurement of optic nerve sheath diameter (ONSD). Abnormal values of ONSD prompted immediate brain computed tomography scan that confirmed high intracranial pressure (ICP) due to multiple deep parenchymal hematomas. Despite raised ICP, values obtained by TCD were normal, thanks to the persistence of cerebral autoregulation. This case highlights the interest of combining noninvasive techniques for neurological examination, especially for sedated patients.


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