Correlation of optic nerve sheath diameter with Rotterdam CT score in traumatic brain injury

Background: Traumatic brain injury poses a significant challenge for trauma victims. Early identification of such injuries in the emergency department can significantly improve patient outcomes. Apart from clinical examination, the optic nerve sheath diameter (ONSD) has been introduced for early diagnosis in the emergency department. Methodology: A prospective analysis of all the patients admitted with suspected head injury who underwent Non-contrast computed tomography (NCCT) head was done. All such patients were evaluated with ultrasound-guided Optic nerve sheath diameter (ONSD) assessment, and the same was correlated with Rotterdam CT score (RCTS). Results: 112 patients were enrolled in the study. The mean age of the study population was 39.02 ± 15.38 years with a male preponderance. ONSD correlated with higher RCTS (>3) with a cut-off value of 5.62 mm as per the receiver operating characteristic curve analysis. The current study identified significant predictors of raised intracranial pressure (ICP), with epidural mass lesions (OR = 1.131, p = 0.017), intraventricular hemorrhage (IVH) or subarachnoid hemorrhage (SAH) (OR = 1.071, p = 0.016), and episodes of vomiting as key predictors. Conclusion: The present study demonstrates that ultrasonographic measurement of the ONSD correlates reliably in patients with traumatic brain injury. Moreover, clinical factors such as vomiting, epidural mass lesions, and intraventricular or subarachnoid haemorrhage were significant predictors of elevated ICP, providing valuable adjunctive criteria for risk stratification in emergency care.