UMEM Educational Pearls

Title: Optic Disc Elevation and Relationship with Head Trauma

Category: Ultrasound

Keywords: POCUS, trauma, optic ultrasound (PubMed Search)

Posted: 2/16/2026 by Alexis Salerno Rubeling, MD (Updated: 2/18/2026)
Click here to contact Alexis Salerno Rubeling, MD

Bottom Line: Left Optic Disc Elevation was found to be an independent predictor of mortality and need for surgical intervention for patients with head trauma.

Additional Information

A recent study aimed to compare the diagnostic and prognostic performance of optic nerve sheath diameter (ONSD) and optic disc elevation (ODE) in patients with head trauma.

A total of 257 patients were included; 51.4% were hospitalized, 12.5% required surgical intervention, and 8.2% experienced in?hospital mortality.

Left ODE was identified as an independent predictor of mortality, with an adjusted hazard ratio (HR) of 4.25 (95% CI, 1.48–12.1; p = 0.007). (Left ODE 1.3 mm with IQR of 0.7 in mortality group). It also demonstrated improved diagnostic performance for predicting the need for surgical intervention. 

Ultrasound Measurements

To measure ODE:
Measure the distance between the anterior peak of the optic disc and its junction with the posterior scleral surface.

To measure ONSD:
Measure 3 mm posterior to the papilla, placing calipers on the outer borders of the hyperechoic rim surrounding the optic nerve sheath.

References

Ahmet S, Nazire BA, Ramazan K. The test characteristics of ONSD and ODE tests in predicting the prognosis of patients with traumatic brain injury. AJEM in press 2026 doi: doi.org/10.1016/j.ajem.2026.02.015