The Relationship Between USG-Based Optic Nerve Sheath Diameter and Manifestations of Increased Intracranial Pressure in Patients with Non-Traumatic Intracranial Lesions in Dr. Soetomo Surabaya Hospital

The incidence of non-traumatic increased intracranial pressure (ICP) associated with intracranial lesions is increasing. These patients exhibit increased morbidity and mortality rates. Immediate identification and timely intervention can reduce the death rate by around 50%. The Optic Nerve Sheath Diameter (ONSD) measurement is a recently developed non-invasive method for measuring intracranial pressure (ICP). It has been shown to be a dependable method. The purpose of this study was to analyze the relationship between ONSD measured by ultrasonography and clinical manifestations such as headache, projectile vomiting, seizures, decreased consciousness, Cushing’s triad, and pupillary diameter in patients with non-traumatic intracranial lesions at Dr. Soetomo Hospital Surabaya. This study is a cross sectional conducted in the emergency room of RSUD Dr. Soetomo from February to April 2023. Patients aged 18-60 with non-traumatic intracranial lesions who underwent a CT scan were selected using consecutive sampling. The optic nerve sheath diameter (ONSD) was evaluated using an ultrasonography in both eyes. The contigency coefficient test was used to determine the association between ONSD and clinical manifestations. The study included 41 subjects, with an average age of 45.66 years. The ONSD diameter was higher than the cut-off point (≥ 5.70 mm) in patients with space occupying lesions, strokes, and central nervous system infections (60%, 47.8%, and 37.5%, respectively). We found a statistically significant association between ONSD of the right and left eye and headache (p<0.05), seizures (p<0.05), Cushing’s triad (p<0.05), and pupillary diameter (p<0.05). In conclusion, there is a significant association between ONSD and clinical manifestations of increased intracranial pressure including headache, seizure, decreased consciousness, Cushing’s triad, and pupillary diameter.