Background: In cases showing cerebrospinal fluid (CSF) redistribution as a compensatory mechanism in acute\nintracranial hypertension, the optic nerve sheath diameter (ONSD) can be used to estimate intracranial pressure\n(ICP). However, it remains unclear whether the ONSD can be applied in patients with skull defects after a craniectomy,\nbecause the primary injury or surgical craniectomy may alter the dynamics of the CSF circulation or structure of the\noptical nerve sheath. This study explored the value of the ONSD in patients after a hemicraniectomy.\nMethods: This prospective observational study enrolled patients after a hemicraniectomy. All patients underwent\ninvasive ICP monitoring and ocular ultrasound within 6 h postoperatively. We followed the patients for 6 months and\nevaluated them using the Glasgow Outcome Score (GOS), classifying the outcome as favorable (GOS 4â??5) or\nunfavorable (GOS 1â??3). We evaluated the ONSD in both according to the ICP and neurological outcome
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