Optic nerve sheath diameter affected by cervical collar placement in minor head trauma patients

Abstract EN

Background: Head trauma may cause an increase in intracranial pressure (ICP).

The use of ocular ultrasound to measure optic nerve sheath diameter (ONSD) is a method to determine the ICP.

The use of the rigid cervical collar in head trauma patients contribute to elevating ICP, and therefore, potentially causing further deterioration in their condition.

Objectives: This study aimed to describe changes in ONSD after the placement of a c-collar and analyze these changes depending on the time in the c-collar.

Methods: This prospective study measured the ONSD of minor head trauma patients before and after the placement of a c-collar.

Patients aged ³18 with blunt head trauma and Glasgow Coma Score ³13 were included in the study.

Each eye was scanned twice.

This was done before c-collar placement, at 5 and 20 min after placement.

The mean values of both eyes were calculated and analyzed.

Results: This study investigated 50 patients.

The mean baseline ONSD was obtained at 4.71mm±0.22 (4.54-4.77).

Furthermore, T5 and T20 measurements were 5.19±0.41 (5.07-5.31) and 5.26±0.45 (5.14-5.39), respectively.

The ONSD increased at T5 and T20.

The changes from the baseline measurements were statistically significant (P=0.000, P=0.000).

The difference between T5 and T20 groups was an increase in ONSD, and these differences were also statistically significant (0.07±0.19; P=0.008).

Conclusion: Our results revealed that minor head trauma patients using a c-collar may increase ONSD by timeline the clinical effects of which have to be determined with further studies.

Enlargement in ONSD should be considered when interpreting ICP.