Utilidad diagnóstica de la ecografía de vaina de nervio óptico (evno), como método no invasivo para la detección de hipertension intracraneal. Estudio prospectivo de 95 mediciones comparado con monitoreo invasivo en Chile

Abstract

Introduction: The endocranial hypertension syndrome (HTEC) is a serious condition with life risk, caused by a large number of neurological and systemic diseases. The reference test for its diagnosis is the invasive measurement of intracranial pressure (PIC). Our hypothesis is that the optic nerve sheath ultrasound is a useful tool as a non-invasive method in the detection of HTEC, compared with the current reference method. Material and Method: Prospective study of anonymized secondary data on the value of the EVNO masked to the value of the PIC by external ventricular drainage (DVE), performed by single operator in adult patients of the Hospital Puerto Montt, between 2015 and 2017. Results: 59 patients were included with a total of 95
measurements. A sensitivity of 88%, specificity of 92% was obtained with a positive predictive value (PPV) and a negative value (NPV) of 85% and 94% respectively. The ROC curve shows an area under the curve of 0.95. Discussion: The results obtained are comparable to those reported in the literature, widely supporting the utility of this non-invasive technique. This is the first work reported in Chile for the validation and dissemination of this ultrasound technique in our local reality. Conclusion: EVNO is an accessible, sensitive and specific technique for the detection of HTEC in a non-invasive way. Its potential is evident beyond the neurointensive, but it should be used as a support tool and not replace invasive monitoring when it is
indicated.