E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Optic Nerve Sheath Diameter in Infantile Hydrocephalus Follow-Up: Clinical Insights from CT-Based Measurements
Ebru Doruk✉ ,
Feyza Karagöz Güzey ,
İlker Güleç ,
Azmi TUFAN ,
Nuri Serdar Baş ,
Lütfi Can ATÇEKEN
Neurosurgery, Bağcılar Eğitim ve Araştırma Hastanesi; Neurosurgery, Health Sciences University Bagcilar Training and Research Hospital; Neurosurgery, Florence Nightingale Hospital
DOI: 10.5137/1019-5149.JTN.50164-25.3
Article in Press
Corresponding Author:
Ebru Doruk (dr_ebrudogan@hotmail.com)
Abstract
Aim
This study evaluated changes in optic nerve sheath diameter (ONSD) values measured by computed tomography (CT) in infants who had undergone surgery for hydrocephalus and assessed their correlation with the Evans index (EI).
Material and Methods
Between January 2016 and December 2024, 75 infants who had undergone ventriculoperitoneal shunt (VPS) surgery were retrospectively analyzed. Preoperative and postoperative CT scans were reviewed and ONSD and EI values were measured. Due to technical limitations such as motion artifacts, poor image quality, or inability to clearly measure the optic nerve sheath, bilateral ONSD measurements could not be performed in approximately 1314% of patients. Data on etiology, postoperative complications, and shunt revision were also recorded and the correlations were investigated.
Results
In 65 patients with analyzable and comparable results, the mean ONSD decreased significantly from 4.34 ± 0.62 mm preoperatively to 3.98 ± 0.42 mm postoperatively (p < 0.001). EI also decreased from 0.384 ± 0.073 to 0.328 ± 0.058 (p < 0.001). A significant correlation was observed between ONSD and EI values (r = 0.46, p < 0.001). Postoperative complications occurred in 13.8%, and 15.4% of patients required shunt revision. Both were associated with increased postoperative ONSD and EI values, but this association was not statistically significant.
Conclusion
CT-based ONSD measurements showed significant correlation with ventricular shrinkage in infantile hydrocephalus, indicating that this could be used as a non-invasive follow-up parameter. Although ultrasonography is generally preferred for ONSD assessment, ONSD measurements on cranial CT can be informative when imaging is available.
This study evaluated changes in optic nerve sheath diameter (ONSD) values measured by computed tomography (CT) in infants who had undergone surgery for hydrocephalus and assessed their correlation with the Evans index (EI).
Material and Methods
Between January 2016 and December 2024, 75 infants who had undergone ventriculoperitoneal shunt (VPS) surgery were retrospectively analyzed. Preoperative and postoperative CT scans were reviewed and ONSD and EI values were measured. Due to technical limitations such as motion artifacts, poor image quality, or inability to clearly measure the optic nerve sheath, bilateral ONSD measurements could not be performed in approximately 1314% of patients. Data on etiology, postoperative complications, and shunt revision were also recorded and the correlations were investigated.
Results
In 65 patients with analyzable and comparable results, the mean ONSD decreased significantly from 4.34 ± 0.62 mm preoperatively to 3.98 ± 0.42 mm postoperatively (p < 0.001). EI also decreased from 0.384 ± 0.073 to 0.328 ± 0.058 (p < 0.001). A significant correlation was observed between ONSD and EI values (r = 0.46, p < 0.001). Postoperative complications occurred in 13.8%, and 15.4% of patients required shunt revision. Both were associated with increased postoperative ONSD and EI values, but this association was not statistically significant.
Conclusion
CT-based ONSD measurements showed significant correlation with ventricular shrinkage in infantile hydrocephalus, indicating that this could be used as a non-invasive follow-up parameter. Although ultrasonography is generally preferred for ONSD assessment, ONSD measurements on cranial CT can be informative when imaging is available.
Keywords
Hydrocephalus
infant
optic nerve sheath diameter
Evans index
computed tomography