الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Raised intracranial pressure is a common life-threatening complication of brain injury in children who admitted to PICU. This group of patients may require rapid diagnosis and therapeutic decisions to avoid future complications.
Thus, its early and timely diagnosis together with the application of effective therapeutic measures are important to guarantee improved patient outcomes. Multimodal neurological monitoring is a crucial component of these patients’ care; it is based on a range of invasive and non-invasive techniques, each with unique properties and applications.
Computed tomography scanning of the head continues to be the preferred modality for the assessment of clinically stable patients since it offers a significant information on the extent of brain damage and the structural state of the central nervous system. In unstable multiorgan-system affected or mechanically ventilated patients, transfer to the imaging department carries a high level of risk and is not recommended; instead ICP must be evaluated using other non-invasive methods.
In a recent years, the ONSD evaluation by ultrasound is considered as a valuable non-invasive technique in recognizing and follow-up raised intracranial pressure. It is a safe non-invasive technique that can be performed at the patient’s bedside, low cost and does not include any radiation concerns. While this technique has been reported in a number of publications, its reliability in comparison to the typical invasive ICP assessment has not been confirmed.
This study was conducted on forty-two patients who had admitted to pediatric intensive care unit who were suspected to have raised intracranial pressure and tested by computed tomography and ONSD in a time difference ranging from thirty minutes to one hour of admission because the ONSD is a point-of-care ultrasonography in the PICU.
In the current study, it was demonstrated that ONSD using ocular ultrasonography represented a rapid bedside diagnostic as well as follow-up tool of the raised ICP that differed significantly in therapeutic actions and detection of the response to the treatment. These actions resulted in a significant decrease in PICU mortality rates.
Finally, raised intracranial pressure continues to be a threat in PICU setting with high morbidity and mortality. Based on this study results, our hope is to use ONSD as a rapid non-invasive method for early detection and management of raised intracranial pressure with the benefit of low rate of radiatio