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J Korean Soc Emerg Med > Volume 26(1); 2015 > Article
Journal of The Korean Society of Emergency Medicine 2015;26(1): 1-8.
Availability of the Optic Nerve Sheath Diameter Measured by Using Facial CT as a Predictive Factor for Traumatic Brain Injury in the Emergency Department
Ho Jung Choi, Hyung Jun Moon, Jung Won Lee, Jong Ho Kim, Dong Kil Jeong, Ki Hwan Kim, Young Ki Kim, Min Jung Ko, Jae Hyung Choi
1Department of Emergency Medicine, Soonchunhyang University Hospital, Cheonan, Korea. daybreakscent@gmail.com
2Department of Emergency Medicine, Soonchunhyang University Hospital, Bucheon, Korea.
Traumatic brain injury (TBI) occurs frequently in patients with facial injuries. In patients with facial injuries without neurologic deficit, it is a challenging decision for emergency physicians whether brain computed tomography (CT) is necessary or not. Our objective is to evaluate the availability of optic nerve sheath diameter (ONSD) measured by facial CT in predicting TBI.
From January, 2010, to December, 2012, we conducted a retrospective study of patients with head or facial injuries who underwent both facial CT and brain CT simultaneously in the emergency department. Patients with obvious orbital trauma or ocular disease were excluded. We analyzed correlation between ONSD measured by facial CT and the brain CT findings of TBI.
A total of 229 patients were enrolled. Ninety six patients without TBI on facial CT showed mean ONSD of 5.11+/-0.44 mm, and 82 patients with TBI showed mean ONSD of 5.89+/-0.78 mm. The sensitivity and the specificity compared with the presence of TBI findings on brain CT were 78.05% and 82.29%, respectively, when the cut-off value was set to 5.5 mm. The area under the curve (AUC) was 0.826 in the receiver operating characteristic curve (ROC curve).
ONSD measured on facial CT is available for predicting TBI in patients with facial injuries.
Key words: Brain injury, Intracranial hypertension, X-ray Computed tomography, Facial injuries, Optic nerve
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