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Sonographic assessment of the optic nerve sheath in idiopathic intracranial hypertension.
J Neurol. 2011 Nov; 258(11):2014-9.JN

Abstract

The aim of this work was to investigate the potential of ultrasound-based optic nerve sheath diameter (ONSD) measurements in detecting raised intracranial pressure in patients with idiopathic intracranial hypertension (IIH) and to describe ONSD response to lumbar puncture. In ten patients with newly diagnosed IIH, transorbital sonography was carried out to assess ONSD, OND (optic nerve diameter), and optic disc elevation before and after lumbar puncture. Twenty-five patients with other neurological disorders served as controls. Subjects with IIH showed a significantly enlarged ONSD on both sides (6.4 ± 0.6 mm vs. 5.4 ± 0.5 mm in controls; p < 0.001). The best cut-off value of ONSD for detecting raised ICP was 5.8 mm with a sensitivity of 90% and a specificity of 84%. After lumbar puncture, ONSD decreased bilaterally (right 5.8 ± 0.7 mm, p < 0.004; left 5.9 ± 0.7 mm, p < 0.043). No post-puncture changes could be observed with regard to OND and optic disc elevation. Sonographic ONSD evaluation may be useful as an additional tool to identify patients with raised intracranial pressure, as in IIH. Furthermore, our data suggest a potential usefulness of this method for monitoring of treatment effects. The degree of ONSD response to lumbar puncture differs in subjects with IIH, which may possibly be related to findings of a defective CSF circulation in the optic nerve sheath in this disorder, a state that is referred to as optic nerve compartment syndrome.

Authors+Show Affiliations

Department of Neurology, Justus-Liebig-University, Klinikstraβe 33, 35385 Giessen, Germany. jochenbaeuerle@gmx.deNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21523461

Citation

Bäuerle, Jochen, and Max Nedelmann. "Sonographic Assessment of the Optic Nerve Sheath in Idiopathic Intracranial Hypertension." Journal of Neurology, vol. 258, no. 11, 2011, pp. 2014-9.
Bäuerle J, Nedelmann M. Sonographic assessment of the optic nerve sheath in idiopathic intracranial hypertension. J Neurol. 2011;258(11):2014-9.
Bäuerle, J., & Nedelmann, M. (2011). Sonographic assessment of the optic nerve sheath in idiopathic intracranial hypertension. Journal of Neurology, 258(11), 2014-9. https://doi.org/10.1007/s00415-011-6059-0
Bäuerle J, Nedelmann M. Sonographic Assessment of the Optic Nerve Sheath in Idiopathic Intracranial Hypertension. J Neurol. 2011;258(11):2014-9. PubMed PMID: 21523461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sonographic assessment of the optic nerve sheath in idiopathic intracranial hypertension. AU - Bäuerle,Jochen, AU - Nedelmann,Max, Y1 - 2011/04/28/ PY - 2011/03/16/received PY - 2011/04/12/accepted PY - 2011/4/28/entrez PY - 2011/4/28/pubmed PY - 2012/3/1/medline SP - 2014 EP - 9 JF - Journal of neurology JO - J Neurol VL - 258 IS - 11 N2 - The aim of this work was to investigate the potential of ultrasound-based optic nerve sheath diameter (ONSD) measurements in detecting raised intracranial pressure in patients with idiopathic intracranial hypertension (IIH) and to describe ONSD response to lumbar puncture. In ten patients with newly diagnosed IIH, transorbital sonography was carried out to assess ONSD, OND (optic nerve diameter), and optic disc elevation before and after lumbar puncture. Twenty-five patients with other neurological disorders served as controls. Subjects with IIH showed a significantly enlarged ONSD on both sides (6.4 ± 0.6 mm vs. 5.4 ± 0.5 mm in controls; p < 0.001). The best cut-off value of ONSD for detecting raised ICP was 5.8 mm with a sensitivity of 90% and a specificity of 84%. After lumbar puncture, ONSD decreased bilaterally (right 5.8 ± 0.7 mm, p < 0.004; left 5.9 ± 0.7 mm, p < 0.043). No post-puncture changes could be observed with regard to OND and optic disc elevation. Sonographic ONSD evaluation may be useful as an additional tool to identify patients with raised intracranial pressure, as in IIH. Furthermore, our data suggest a potential usefulness of this method for monitoring of treatment effects. The degree of ONSD response to lumbar puncture differs in subjects with IIH, which may possibly be related to findings of a defective CSF circulation in the optic nerve sheath in this disorder, a state that is referred to as optic nerve compartment syndrome. SN - 1432-1459 UR - https://www.unboundmedicine.com/medline/citation/21523461/Sonographic_assessment_of_the_optic_nerve_sheath_in_idiopathic_intracranial_hypertension_ L2 - https://dx.doi.org/10.1007/s00415-011-6059-0 DB - PRIME DP - Unbound Medicine ER -