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NAAS Score: *5.38 (2020)
[Effective from January 1, 2020]
For more details click here
ICV 2023: 95.56
Index Copernicus ICI Journals Master List 2023 - IJCMAS--ICV 2023: 95.56
For more details click here
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Original Research Articles Volume : 15, Issue : 6, June, 2026

PRINT ISSN : 2319-7692
Online ISSN : 2319-7706
Issues : 12 per year
Publisher : Excellent Publishers
Email : editorijcmas@gmail.com
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Editor-in-chief: Dr.M.Prakash
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Int.J.Curr.Microbiol.App.Sci.2026.15(6) : 103-110
DOI : https://doi.org/10.20546/ijcmas.2026.1506.010


Non-Invasive Assessment of Cerebral Edema in Traumatic Brain Injury: A Comparative Review of Radiological Imaging, Optic Nerve Sheath Diameter, and Ophthalmoscopy

Visolat Khamzaevna Sharipova1 and Temur Khayrullaevich Ashurov2*
1Doctor of Medical Sciences, Professor, Scientific Director of the Department of Anesthesiology and Resuscitation at the Republican Scientific Center for Emergency Medical Care, Tashkent, Uzbekistan 2Postgraduate Student in the Basic Doctoral Program at the Bukhara State Medical Institute, Bukhara, Uzbekistan
*Corresponding author
Abstract:

Traumatic brain injury (TBI) initiates a destructive cascade of secondary pathophysiological processes, primarily post-traumatic cerebral edema, which drives intracranial hypertension and severely worsens clinical outcomes. Although invasive intracranial pressure (ICP) monitoring remains the historical gold standard, its practical utility is limited by procedural risks such as infection and hemorrhage, alongside a shortage of neurosurgical resources in resource-limited settings. Consequently, establishing reliable non-invasive diagnostic strategies has become crucial in modern neurocritical care. This review provides a comparative analysis of three key non-invasive modalities operating along the craniospinal axis: radiological imaging (CT/MRI), ultrasound-guided optic nerve sheath diameter (ONSD) measurement, and ophthalmoscopy. While neuroimaging serves as the macro-structural baseline for identifying mass effect and edema volume, point-of-care ultrasound of the ONSD acts as a dynamic, real-time proxy for acute ICP fluctuations. Concurrently, ophthalmoscopy evaluates the visual endpoint of sustained intracranial hypertension through papilledema assessment. By synthesizing the diagnostic sensitivity, latency, and operational limitations of each method, this paper establishes an integrated clinical framework to optimize bedside triage and therapeutic monitoring for patients with cerebral edema.


Keywords: Traumatic brain injury; Cerebral edema; Non-invasive monitoring; Optic nerve sheath diameter; Ophthalmoscopy; Neuroimaging.

References:
  1. Abhay K, et al., Non-mydriatic fundus photography in neurocritical care: A diagnostic tool for intracranial pressure. Neurology India. 2024; 72(4): 901–908. https://doi.org/10.4103/ni.ni_234_24
  2. Arfanakis K, Haughton VM, Carew JD, et al., Diffusion Tensor MR Imaging in Diffuse Axonal Injury. AJNR Am J Neuroradiol. 2002; 23: 794-802.
  3. Bakhos JJ, et al., The role of NSAIDs in neurocritical care: benefits and risks. Journal of Clinical Medicine. 2021; 10(4): 654. https://doi.org/10.3390/jcm10040654.
  4. Balkrishna A, et al., Anti-inflammatory and antioxidant activities of Nimesulide in neurodegenerative models. Scientific Reports. 2023; 13(1): 14231. https://doi.org/10.1038/s41598-023-41256-w
  5. Brain Trauma Foundation. Guidelines for the Management of Severe Traumatic Brain Injury, 4th Edition. Neurosurgery. 2020. (Reference Guidelines).
  6. Cederberg D, Siesjö P. What has inflammation to do with traumatic brain injury? Child's Nervous System. 2010; 26(4): 421–426.

 https://doi.org/10.1007/s00381-009-1029-x

  1. Czosnyka M, Pickard JD. Monitoring and interpretation of intracranial pressure. Journal of Neurology, Neurosurgery & Psychiatry. 2004; 75(6): 813–821. https://doi.org/10.1136/jnnp.2003.033126
  2. Dölen D, et al., Kafa Travmasında Beyin Ödemi ve İntrakranyal Basınç Değişimleri. Türk Nöroşirürji Dergisi. 2020; 30(2): 187-193.
  3. Ferreira F.M., Lino B.T., Giannetti A.V. Ultrasonographic evaluation of optic nerve sheath diameter in severe traumatic brain injury patients: a comparison with intraparenchymal pressure monitoring. Research Square. – 2024. – P. 1-16.
  4. Gao H, Chen X, Zhang J. COX-2/PGE2 pathway and blood-brain barrier disruption in traumatic brain injury. Brain Research Bulletin. 2022; 183: 114–124. https://doi.org/10.1016/j.brainresbull.2022.02.022
  5. García-Domínguez M. Neuroinflammation: Mechanisms, Dual Roles, and Therapeutic Strategies in Neurological Disorders // Current Issues in Molecular Biology. — 2025. — Vol. 47, No. 1. — Art. 417. — 33 p. — https://doi.org/10.3390/cimb47010417.
  6. Gurung J, et al., Neuro-ophthalmic manifestations in traumatic brain injury: a hospital-based study from Nepal. Annals of Medicine & Surgery. 2024; 86: 1920-1924. https://doi.org/10.1097/MS9.0000000000001818.
  7. Haqberdiev T, et al., Dynamics of GCS and NLR in patients with brain edema receiving augmented therapy. Central Asian Medical Journal. 2025; 12(3): 45–52.
  8. Harris G, et al., Review: Emerging Eye-Based Diagnostic Technologies for Traumatic Brain Injury. IEEE Reviews in Biomedical Engineering. 2023; 16: 530-553. https://doi.org/10.1109/RBME.2022.3161352.
  9. Hinson HE, et al., Neuroinflammation in traumatic brain injury: an opportunity for treatment. Current Opinion in Critical Care. 2015; 21(2): 111–117. https://doi.org/10.1097/MCC.0000000000000182
  10. Jassam SA, et al., Neuroinflammation and the blood-brain barrier in traumatic brain injury. Journal of Neuroinflammation. 2017; 14(1): 84. https://doi.org/10.1186/s12974-017-0857-2
  11. Kiconco MB, Kiryabwire J, Erem G, Kakande I. Rotterdam CT score as a predictor for early death among patients with traumatic brain injury at a tertiary hospital in Kampala, Uganda: a prospective study. East Cent Afr J Surg. 2023; 28(4): 116-121. https://doi.org/10.4314/ecajs.v28i4.4.
  12. Klimo KR, et al., Structure and function of retinal ganglion cells in subjects with a history of repeated traumatic brain injury. Frontiers in Neurology. 2022; 13: 963587. https://doi.org/10.3389/fneur.2022.963587.
  13. Knighton AJ, Wolfe D, Hunt A, et al., Improving Head CT Scan Decisions for Pediatric Minor Head Trauma in General Emergency Departments: A Pragmatic Implementation Study. Ann Emerg Med. 2022; 80(4): 332-343. https://doi.org/10.1016/j.annemergmed.2022.04.030.
  1. Koshy P, et al., Measurement of Optic Nerve Sheath Diameter by Bedside Ultrasound in Patients With Traumatic Brain Injury Presenting to Emergency Department: A Review. Cureus. 2024; 16(6): e61768. https://doi.org/10.7759/cureus.61768.
  2. Lozano R, et al., Global, regional, and national burden of traumatic brain injury. The Lancet Public Health. 2022; 7(1): e23–e35. https://doi.org/10.1016/S2468-2667(21)00189-4
  3. Maas AIR, et al., Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. The Lancet Neurology. 2022; 21(5): 419–463. https://doi.org/10.1016/S1474-4422(22)00009-7
  4. Martínez-Palacios K., Vásquez-García S., Fariyike O.A. and others. Using Optic Nerve Sheath Diameter for Intracranial Pressure (ICP) Monitoring in Traumatic Brain Injury: A Scoping Review. Neurocritical Care. – 2024. – P. 1193–1212.
  5. McKee AC, Daneshvar DH. The neuropathology of traumatic brain injury. Handb Clin Neurol. 2015; 127: 45-66. https://doi.org/10.1016/B978-0-444-52892-6.00004-0.
  6. Morganti-Kossmann MC, et al., Role of inflammation in secondary edema and brain injury. Neurotherapeutics. 2019; 16(2): 309–322. https://doi.org/10.1007/s13311-019-00715-3
  7. Pignataro G., Sacco Fernandez M., Candelli M. (et al.,) Blood-Based Biomarkers for Traumatic Brain Injury: A New Era in Diagnosis and Prognosis // International Journal of Molecular Sciences. — 2025. — Vol. 26, No. 24. — Art. 12158. — 21 p. — https://doi.org/3390/ijms262412158;
  8. Puccio AM, Yue JK, Korley FK, et al., Diagnostic Utility of Glial Fibrillary Acidic Protein Beyond 12 Hours After Traumatic Brain Injury: A TRACK-TBI Study. Journal of Neurotrauma. 2024; 41: 1353-1363. https://doi.org/10.1089/neu.2023.0186.
  9. Sahu JK, et al., Nimesulide as a Neuroprotective Agent: Molecular Mechanisms and Clinical Prospects. Frontiers in Pharmacology. 2023; 14: 1102453. https://doi.org/10.3389/fphar.2023.1102453
  10. Sharma PK, et al., Computed Tomography Optic Nerve Sheath Diameter-to-Eyeball Transverse Diameter Ratio as a Novel Noninvasive Parameter for Prognostication in Traumatic Brain Injury. Cureus. 2024; 16(8): e68297. HTTPS://DOI.ORG/10.7759/cureus.68297.
  11. Simon DW, et al., The systemic immune response to traumatic brain injury. Nature Reviews Neurology. 2017; 13(3): 171–184. https://doi.org/10.1038/nrneurol.2016.204
  12. Stocchetti N, Maas AI. Traumatic intracranial hypertension. New England Journal of Medicine. 2014; 370(22): 2121–2130. https://doi.org/10.1056/NEJMra1208708
  13. Sulejmanpasic A, Tanovic A. Role of COX-2 Inhibitors in Preventing Secondary Brain Injury: A Systematic Review. Neurocritical Care. 2024; 40(2): 512–525. https://doi.org/10.1007/s12028-023-01844-w
  14. Švraka D, et al., Clinical Significance of the Control CT Rotterdam Score Compared With the Admission CT Rotterdam Score in Patients With Isolated Severe Traumatic Brain Injury in the Intensive Care Unit. Cureus. 2024; 16(9): e69792. https://doi.org/10.7759/cureus.69792.
  15. Taneja N, et al., Evaluation of Nimesulide in severe traumatic brain injury: a randomized controlled trial update. Journal of Neurotrauma. 2025; 42(1): 88–95. https://doi.org/10.1089/neu.2024.0412
  16. Teoh L, Ihalage AA, Harp S, et al., Deep learning for behaviour classification in a preclinical brain injury model. PLoS ONE. 2022; 17(6): e0268962. https://doi.org/10.1371/journal.pone.0268962.
  17. Vane JR, Botting RM. Mechanism of action of nonsteroidal anti-inflammatory drugs. The American Journal of Medicine. 1998; 104(3): 2S–8S. https://doi.org/10.1016/s0002-9343(98)00032-9
  18. Wang J, Hu Y, Wu P. Risk factors for positive brain CT scan in children with traumatic brain injury and GCS=15: A retrospective study. Medicine. 2021; 100: 4(e24543). https://doi.org/10.1097/MD.0000000000024543.
  1. Yue JK, Yuh EL, Elguindy MM, et al., Isolated Traumatic Subarachnoid Hemorrhage on Head Computed Tomography Scan May Not Be Isolated: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (TRACK-TBI) Study. Journal of Neurotrauma. 2024; 41: 1310-1322. https://doi.org/10.1089/neu.2023.0253.
  2. Zeiler FA, et al., Neutrophil-to-Lymphocyte Ratio as a Predictor of Outcomes in Severe Traumatic Brain Injury. World Neurosurgery. 2020; 135: e345–e352. https://doi.org/10.1016/j.wneu.2019.11.086
  3. Zhou L., Flores J., Noël A. (et al., ) Methylene blue inhibits Caspase-6 activity, and reverses Caspase-6-induced cognitive impairment and neuroinflammation in aged mice // Acta Neuropathologica Communications. — 2019. — Vol. 7. — Art. 210. — https://doi.org/10.1186/s40478-019-0856-6.
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How to cite this article:

Visolat Khamzaevna Sharipova and Temur Khayrullaevich Ashurov. 2026. Non-Invasive Assessment of Cerebral Edema in Traumatic Brain Injury: A Comparative Review of Radiological Imaging, Optic Nerve Sheath Diameter, and Ophthalmoscopy. Int.J.Curr.Microbiol.App.Sci. 15(6): 103-110 doi: https://doi.org/10.20546/ijcmas.2026.1506.010
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