Introduction: Raised intracranial pressure (ICP) is a common life-threatening condition that can occur in multiple neurological or non-neurological settings.Traumatic brain injury (TBI) is one of the main causes of increased intracranial pressure .Raised intracranial pressure has multiple catastrophic results as it decreases the cerebral blood flow and causes global iscahemia to the brain leading finally to brain death.(1) There is a multiple methods to monitor the intracranial pressure either invasive or non invasive . The gold standard method for diagnosing raised ICP is the use of invasive intracranial devices.This method is the most accurate and reliable . However, this requires an surgical intervention that has multiple…show more content… Virtually, the probe was gently placed on the upper eyelid after administration of sterile gel on the closed eye led , without pressure, in the linear horizontal orientation for both the right and left optic nerve sheaths in the horizontal plane. Placement of the probe was adjusted to give a suitable angle for displaying entry of the optic nerve into the globe. The ONSD was measured 3mm longitudinally from the location of the retina in each eye , using an electronic caliper and an axis perpendicular to the optic nerve. The mean value of the right and left ONSD was used in the analysis .we used a cut off value for ONSD as 4.8 mm to diagnose ICP> 20 mm hg.(2) all patients with signs of increased ICP had received mannitol 20 % in a dose of 0.5 gm /kg every 6 hours for 48 hours slowly over a period of 20 minutes. recorded data : data were recorded at multiple points 20 minutes after end of mannitol infusion then at 2 hours , 6 hours , 12 hours , 24 hours and 48 hours . the data that were obtained were ONSD , GCS , Haemodynamic values ( heart rate ,mean arterial blood pressure ) .
Another CT scan were performed 48 hours after admission and Marshall scale were
