Avaliação ultrassonográfica da bainha do nervo óptico como preditor de gravidade e complicações em pacientes submetidos a procedimento cirúrgico de exérese tumor cerebral

Abstract

Transorbital ultrasound (TUB) with measurement of optic nerve sheath diameter (NOB) is an easily viable non-invasive diagnostic tool, allowing the quantification of optic nerve diameters and their sheaths, serving as an indirect assessment of intracranial hypertension, in this context we will to correlate the degree of optic nerve sheath distention with postoperative functional outcomes in patients with brain tumors. Methodology: This study is a prospective cohort, which evaluated optic nerve sheath ultrasonography (UBNO) in patients diagnosed with brain tumor undergoing surgery. UBNO was performed preoperatively, immediately after surgery and at 3 months. The primary endpoint was the Karnofski score (KPS) assessment at 3 months. Results: Thirty-one patients were evaluated, with a mean age of 50 years. A GCS less than 14 fitted almost perfectly with the outcome, as did a preoperative KPS less than 70. A preoperative UBNO value greater than 6.1 mm was also predicted to have an unfavorable outcome in 3 months almost perfect (p<0.0001). The preoperative UBNO ROC curve was 0.96 (95%CI 0.89-1, p=0.0002). There was a significant reduction in the measurement of BNO in the postoperative period (p=0.001). Conclusion: Preoperative measurement of BNO appears to be associated with functional outcome and 3-month mortality in patients undergoing brain tumor resection. In the present study, the cutoff point for BNO measurement for favorable or unfavorable prognosis was 6.1 mm.