Integrated optic nerve sheath diameter, glasgow coma scale and computed tomography-based model for early prediction of clinically significant brain injury in head trauma: A prospective observational study

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Title	Integrated optic nerve sheath diameter, glasgow coma scale and computed tomography-based model for early prediction of clinically significant brain injury in head trauma: A prospective observational study
Authors	Chandan K. Deyą, Merin John˛, Pallavi Shendeą, Varun Anandą, Biraj Majumderą, Sudarsan Beherał, Ramaswamy N⁴, Klein Dantis⁵ & Santosh K. Rathiaą,*
Affiliation	¹Department of Trauma & Emergency, All India Institute of Medical Sciences, Raipur, India; ²Department of Emergency Medicine, Malankara Orthodox Syrian Church Medical College, Kerala, India; ³Department of Orthopedics, All India Institute of Medical Sciences, Deoghar, India; ⁴Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Raipur, India; ⁵Department of CTVS, All India Institute of Medical Sciences, Bathinda, India; *Corresponding author
Email	Chandan K. Dey - E-mail: chandandey@aiimsraipur.edu.in Merin John - E-mail: merinjohn.jan7@gmail.com Pallavi Shende - E-mail: te_pallavishende@aiimsraipur.edu.in Varun Anand - E-mail: varun1616@gmail.com Biraj Majumder - E-mail: dr.birajmajumder@gmail.com Sudarsan Behera - E-mail: sudarsanctc@gmail.com Ramaswamy N - E-mail: nagappanramaswamy@gmail.com Klein Dantis - E-mail: drkleindantis86@gmail.com Santosh K. Rathia - E-mail: drsantoshrathia@aiimsraipur.edu.in; Phone: +91 9891611996
Article Type	Research Article
Date	Received June 1, 2026; Revised June 30, 2026; Accepted June 30, 2026, Published June 30, 2026
Abstract	Acute head injury requires rapid identification of clinically significant brain injury (CSBI), yet access to CT imaging is often limited, creating challenges in early triage. In this prospective study of 215 head trauma patients, optic nerve sheath diameter (ONSD) and Glasgow Coma Scale (GCS) were evaluated as predictors of CSBI. Patients with CSBI had significantly higher ONSD and lower GCS and both variables independently predicted injury severity. The combined ONSD + GCS model demonstrated better diagnostic performance, clinical utility and calibration than either parameter alone, with ONSD showing a dose–response relationship with CT severity. Thus, data shows the validating a practical bedside risk stratification approach that integrates ultrasound-derived ONSD with GCS to improve CSBI prediction, particularly in resource-limited settings.
Keywords	Optic nerve sheath diameter (ONSD), glasgow coma scale (GCS), clinically significant brain injury (CSBI), point-of-care ultrasound, decision curve analysis, rotterdam score
Citation	Dey et al. Bioinformation 22(6): 3762-3767 (2026)
Edited by	Ruby Singh
ISSN	0973-2063
Publisher	Biomedical Informatics
License	This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.