Description

Patients with acute brain pathology (i.e., acute ischemic stroke, intracranial hemorrhage, subarachnoid hemorrhage, and traumatic brain injury) can develop the feared complication of increased intracranial pressure. Orbital ultrasound can be used as a complementary diagnostic tool for non-invasive measurements of intracranial pressure using optic nerve sheath diameter and assessment of papilledema and may be especially ideal for patients unable to travel given their stability or for patients for whom invasive intracranial monitors are contraindicated [7]. Additionally, other orbital pathologies can be detected by bedside ultrasound, including retinal hemorrhage, retinal detachments, vitreous hemorrhage, and lens dislocation. Earlier detection of these can prompt a more timely ophthalmology consultation. The ACEP Policy Statement of Ultrasound Guidelines describes the use of emergency orbital ultrasound for detection of orbital pathology and optic nerve sheath diameter for diseases of the central nervous system [3]. There are no needs assessments specific for neurocritical care practitioners with regards to orbital ultrasound; however, internal feedback from Neurocritical Care Society members indicates a desire to learn more about this diagnostic tool.