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Blood pressure, Intracranial pressure, Optic nerve sheath diameter, Pulsatility index



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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.


Monitoring intracranial pressure (ICP) has become an important practice in patients with elevated ICP (e.g., traumatic brain injury) to improve patient outcome. However, little information exists surrounding chronic, but sub-clinical elevations in ICP, which may stem from classic cardiovascular risk factors, such as elevated blood pressure (BP). The current methods to assess ICP are invasive and costly; but optic nerve sheath diameter (ONSD) and blood flow pulsatility (pulsatility index; PI) are promising non-invasive techniques, both of which have been reported to strongly correlate with invasive measures of ICP in pathology. However, the interactions of BP, ONSD and PI in otherwise healthy adults, remains undetermined. Accordingly, the purpose of this investigation was to determine the relationship between ONSD, PI and BP, and to highlight possible sex differences in a population of young healthy adults. Sixteen participants (6 females) underwent assessment of arterial BP, ONSD (left and right eyes) and PI (left common carotid artery) using ultrasound. There was a strong correlation between mean ONSD (left and right eye combined) and PI (R=0.735, p=0.001). There was no significant relationship between PI and BP (R=0.058, p=0.832) or ONSD and BP (R=0.272, p=0.309). Additionally, there was a significant difference between males and females for mean ONSD, whereby males demonstrated a larger diameter (males=0.4860.110 vs. females=0.3530.062cm; p=0.018), but there was no significant difference in PI between males and females (males=2.3630.613 vs. females=1.9500.196; p=0.136). Results of this study confirm the relationship between ONSD and PI in a healthy population. While ICP was not directly assessed in the current study, the strong associations between ONSD and PI suggest that their combined assessment may be employed as a tenable surrogate to non-invasively measure ICP when the invasive measure of ICP is unfeasible.

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