Measurement of Optic Nerve Sheath Diameter to Detect Increased Intracranial Pressure in Hypertensive Patients

Aim: Our aim was to measure optic nerve sheath diameter (ONSDM) by ultrasonography and to detect whether optic nerve sheath diameter reflects intracranial pressure in hypertensive patients.
Materials and Methods: This observational study was performed prospectively on 149 individuals, of whom 77 (51.7%) were female, including 54 hypertensive-symptomatic patients, 45 hypertensive-asymptomatic patients, and 50 healthy volunteers referred to Emergency Medicine Service of Necmettin Erbakan University, Meram Faculty of Medicine. Blood pressure was measured on the right and left upper extremity by the same sphygmomanometer following at least five minutes of rest. ONSDM was recorded. All measurements of hypertensive-symptomatic patients were repeated at 30th minute following antihypertensive therapy.
Results: Moderate-to-well statistically significant correlations were determined between initial mean systolic blood pressure and ONSDM (rho=0.629, p=0.001) as well as between initial mean diastolic blood pressure and ONSDM (rho=0.561, p=0.001) in all study groups. Statistically significant differences were determined between the mean pre and post-treatment systolic and diastolic blood pressures as well as the mean pre and post-treatment ONSDM values of 40 patients who received antihypertensive therapy (p=0.000, p=0.000, p=0.000, respectively).
Conclusion: ONSDM by ultrasonography reflected increased intracranial pressure in hypertensive patients. The reduction of intracranial pressure was also detected by the same method following antihypertensive treatment. Ultrasonographic ONSDM along with clinical findings and blood pressure measurements may be used for evaluation of response to treatment and deciding on further imaging.