Korelasi Antara Optic Nerve Sheath Diameter dengan Manifestasi Peningkatan Tekanan Intrakranial pada Lesi Intrakranial Non Traumatik

Abstract

Latar belakang: Pasien yang mengalami gangguan otak akibat lesi intrakranial dapat mengakibatkan bertambahnya volume intrakranial sehingga menyebabkan tekanan menjadi tinggi. Pengukuran Optic Nerve Sheath Diameter (ONSD) merupakan metode baru bagi pengukuran TIK non-invasif Tujuan: untuk mengetahui korelasi antara optic nerve sheath diameter dengan manifestasi peningkatan tekanan intrakranial pada lesi intrakranial non-traumatik. Metode Penelitian: Desain potong lintang. Pengambilan sampel dilakukan di Instalasi Radiologi dan Ruang rawat inap terpadu Rumah Sakit Umum Pusat Haji Adam Malik Medan. Sampel penelitian diambil sebanyak 41 subjek secara konsekutif. Pengukuran ONSD dengan Computerized Tomography Scanning (CT Scan) dan pemeriksaan manifestasi klinis peningkatan TIK. Analisis data menggunakan uji koefisien kontigensi. Hasil Penelitian: Rerata usia subjek sebesar 47,3±15,1 tahun, rentang usia terbanyak pada usia ≥46 – 55 tahun (26,8 %), laki-laki (53,7%). Rerata ONSD (5,50±0,9 mm dan 5,65±0,9 mm). Diagnosis lesi intrakranial non-traumatik terbanyak adalah stroke (56,1%). Rerata ONSD space occupying lesion (5,51±0,73 mm dan 5,62±0,78 mm), Stroke (5,43±0,91 mm dan 5,62±0,96 mm) dan Infeksi SSP (5,70 ± 1,14 mm dan 5,78±0,98 mm). Manifestasi klinis peningkatan TIK terbanyak berupa nyeri kepala 51,2%, diikuti penurunan kesadaran 48,8%, papil edema 31,7%, triad cushing 29,3%, pupil anisokor 22%, kejang 19,5%, dan muntah proyektil 17,1%. Kesimpulan: Terdapat korelasi yang signifikan antara ONSD dengan manifestasi klinis peningkatan tekanan intrakranial dengan arah korelasi positif dan keluatan korelasi sedang.

Background: Patients who experience brain disorders due to intracranial lesions can result in increased intracranial volume causing high pressure. Optic Nerve Sheath Diameter (ONSD) measurement is a new method for non-invasive measurement of ICP Objective: to determine the correlation between optic nerve sheath diameter and the manifestation of increased intracranial pressure in non-traumatic intracranial lesions. Research Methods: Cross-sectional design. Sampling was carried out at the Radiology Installation and Integrated Inpatient Room at Haji Adam Malik General Hospital Medan. The research sample was taken as many as 41 subjects consecutively. Measurement of ONSD with Computerized Tomography Scanning (CT Scan) and examination of clinical manifestations of increased ICP. Data analysis used contingency coefficient test. Research Results: The mean age of the subjects was 47.3±15.1 years, the highest age range was ≥46 – 55 years (26.8 %), male (53.7%). Mean ONSD (5.50±0.9 mm and 5.6 ±0.9 mm). The most common diagnosis of non-traumatic intracranial lesions was stroke (56.1%). Mean ONSD space occupying lesion (5.51 ± 0.73 mm and 5.62±0.78 mm), Stroke (5.43±0.91 mm and 5.62±0.96 mm) and CNS infection (5 .70±1.14 mm and 5.78±0.98 mm). The most clinical manifestations of increased ICP were headache 51.2%, followed by decreased consciousness 48.8%, papilledema 31.7%, Cushing's triad 29.3%, pupil anisokor 22%, seizures 19.5%, and projectile vomiting 17 ,1%. Conclusion: There is a significant correlation between ONSD and clinical manifestations of increased intracranial pressure with a positive correlation direction and a moderate correlation output.