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Sonographic assessment of the optic nerve sheath diameter in the diagnosis of idiopathic intracranial hypertension.
J Neurol Sci. 2016 Feb 15; 361:122-7.JN

Abstract

OBJECTIVE

Sonographic assessment of the optic nerve sheath diameter (ONSD) is a useful technique in detecting raised intracranial pressure (ICP) in neurocritical care patients. Its utility in idiopathic intracranial hypertension (IIH) is less known. The aim of this study was to evaluate the diagnostic accuracy of ONSD for detecting IIH.

MATERIAL AND METHODS

Ultrasound measurement of ONSD was performed in 19 patients with IIH and in 11 patients with different neurological diseases without raised ICP that required undergoing a lumbar puncture. The validity of this technique for diagnosing IIH was established with cerebrospinal fluid manometry values.

RESULTS

Patients with IIH showed significantly enlarged ONSD than those without IIH. The best cut-off point for detecting raised ICP was 6.3 mms, with a sensitivity, specificity and positive likelihood ratio of 94.7%, 90.9% and 10.4, respectively. After a therapeutic lumbar puncture an 87% of cases had a partial reduction of ONSD values.

CONCLUSION

Sonographic assessment of ONSD seems to be a useful and reliable technique for detecting raised ICP. While the spinal manometry is not replaced in usual clinical settings, transorbital sonography alternatively allows a suitable and harmless screening of patients with suspected IIH. It would be desirable to perform an internal validation of the technique in each hospital in order to get the optimal cut-off point.

Authors+Show Affiliations

Neurology Department, La Mancha Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain. Electronic address: pablodelsaz1@gmail.com.Investigation, Teaching and Training Unit, La Mancha Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain.Neurology Department, La Mancha Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain.Neurology Department, La Mancha Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain.Neurology Department, La Mancha Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain.Neurology Department, La Mancha Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26810528

Citation

del Saz-Saucedo, Pablo, et al. "Sonographic Assessment of the Optic Nerve Sheath Diameter in the Diagnosis of Idiopathic Intracranial Hypertension." Journal of the Neurological Sciences, vol. 361, 2016, pp. 122-7.
del Saz-Saucedo P, Redondo-González O, Mateu-Mateu Á, et al. Sonographic assessment of the optic nerve sheath diameter in the diagnosis of idiopathic intracranial hypertension. J Neurol Sci. 2016;361:122-7.
del Saz-Saucedo, P., Redondo-González, O., Mateu-Mateu, Á., Huertas-Arroyo, R., García-Ruiz, R., & Botia-Paniagua, E. (2016). Sonographic assessment of the optic nerve sheath diameter in the diagnosis of idiopathic intracranial hypertension. Journal of the Neurological Sciences, 361, 122-7. https://doi.org/10.1016/j.jns.2015.12.032
del Saz-Saucedo P, et al. Sonographic Assessment of the Optic Nerve Sheath Diameter in the Diagnosis of Idiopathic Intracranial Hypertension. J Neurol Sci. 2016 Feb 15;361:122-7. PubMed PMID: 26810528.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sonographic assessment of the optic nerve sheath diameter in the diagnosis of idiopathic intracranial hypertension. AU - del Saz-Saucedo,Pablo, AU - Redondo-González,Olga, AU - Mateu-Mateu,Ángel, AU - Huertas-Arroyo,Rafael, AU - García-Ruiz,Rafael, AU - Botia-Paniagua,Enrique, Y1 - 2015/12/21/ PY - 2015/10/14/received PY - 2015/11/26/revised PY - 2015/12/20/accepted PY - 2016/1/27/entrez PY - 2016/1/27/pubmed PY - 2016/10/21/medline KW - Cerebrospinal fluid KW - Headache KW - Intracranial hypertension KW - Neurosonology KW - Optic nerve SP - 122 EP - 7 JF - Journal of the neurological sciences JO - J Neurol Sci VL - 361 N2 - OBJECTIVE: Sonographic assessment of the optic nerve sheath diameter (ONSD) is a useful technique in detecting raised intracranial pressure (ICP) in neurocritical care patients. Its utility in idiopathic intracranial hypertension (IIH) is less known. The aim of this study was to evaluate the diagnostic accuracy of ONSD for detecting IIH. MATERIAL AND METHODS: Ultrasound measurement of ONSD was performed in 19 patients with IIH and in 11 patients with different neurological diseases without raised ICP that required undergoing a lumbar puncture. The validity of this technique for diagnosing IIH was established with cerebrospinal fluid manometry values. RESULTS: Patients with IIH showed significantly enlarged ONSD than those without IIH. The best cut-off point for detecting raised ICP was 6.3 mms, with a sensitivity, specificity and positive likelihood ratio of 94.7%, 90.9% and 10.4, respectively. After a therapeutic lumbar puncture an 87% of cases had a partial reduction of ONSD values. CONCLUSION: Sonographic assessment of ONSD seems to be a useful and reliable technique for detecting raised ICP. While the spinal manometry is not replaced in usual clinical settings, transorbital sonography alternatively allows a suitable and harmless screening of patients with suspected IIH. It would be desirable to perform an internal validation of the technique in each hospital in order to get the optimal cut-off point. SN - 1878-5883 UR - https://www.unboundmedicine.com/medline/citation/26810528/Sonographic_assessment_of_the_optic_nerve_sheath_diameter_in_the_diagnosis_of_idiopathic_intracranial_hypertension_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(15)30098-8 DB - PRIME DP - Unbound Medicine ER -