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Feasibility and usefulness of ultrasonography in idiopathic intracranial hypertension or secondary intracranial hypertension.
BMC Neurol. 2016 Jun 02; 16:85.BN

Abstract

BACKGROUND

Transorbital sonography (TOS) has been proven to be able to non-invasively detect elevated intracranial pressure. In this condition TOS shows an increase in optic nerve sheath diameter (ONSD). It has been suggested that internal jugular vein valve insufficiency (IJVVI) may represent a factor contributing to the pathogenesis of idiopathic intracranial hypertension (IIH). The aim of this study was to investigate whether patients with IIH or secondary IH have higher ONSD values and higher frequency of IJVVI compared to subjects without IH.

METHODS

Twenty-one patients with newly diagnosed IIH or secondary IH were prospectively evaluated and compared with 21 age, gender and BMI-matched controls. Experienced vascular sonographers used B-mode TOS to evaluate ONSD, optic nerve diameter (OND) and IJVVI. CSF opening pressures were also measured.

RESULTS

ONSD values were significantly higher in patients (6.50 ± 0.67) than controls (5.73 ± 0.66; p < 0.0001). No differences were found in OND values between patients (2.99 ± 0.26) and controls (2.93 ± 0.41; p = 0.574). No correlation was demonstrated between ONSD and CSF opening pressure (r = 0,086) (p = 0.73). No difference in frequency of IJVVI between patients (11/42 valves, 26 %) and controls (9/42, 21 %) was observed (p = 0.777).

CONCLUSIONS

Increased ONSD values detected by TOS support the diagnosis of IH. Our results do not support the hypothesis of a venous congestion as a potential factor contributing to the pathogenesis of IIH.

TRIAL REGISTRATION

Not applicable. Observational, non-interventional study.

Authors+Show Affiliations

Department of Neurology, University of the Saarland, Homburg Saar, Germany. Department of Translational Medicine, Section of Neurology, University of Piedmont East "A. Avogadro", Novara, Italy.Department of Neurological, Biomedica, and Movement Sciences, University of Verona, Verona, Italy.Neurology Unit, Stroke Unit, IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.Department of Neurology, General Hospital Madonna del Soccorso, San Benedetto del Tronto, Italy.Department of Translational Medicine, Section of Neurology, University of Piedmont East "A. Avogadro", Novara, Italy.Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.Department of Translational Medicine, Section of Neurology, University of Piedmont East "A. Avogadro", Novara, Italy.Department of Internal Medicine, Health Sciences, University "A. Avogadro", Novara, Italy.Neurological Practice, and Department of Neurology, Justus-Liebig-University Giessen, Juergen-Ponto-Platz 2, D-60329, Frankfurt am Main, Germany. erwin.stolz@neuro.med.uni-giessen.de.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

27250852

Citation

Lochner, Piergiorgio, et al. "Feasibility and Usefulness of Ultrasonography in Idiopathic Intracranial Hypertension or Secondary Intracranial Hypertension." BMC Neurology, vol. 16, 2016, p. 85.
Lochner P, Brio F, Zedde ML, et al. Feasibility and usefulness of ultrasonography in idiopathic intracranial hypertension or secondary intracranial hypertension. BMC Neurol. 2016;16:85.
Lochner, P., Brio, F., Zedde, M. L., Sanguigni, S., Coppo, L., Nardone, R., Naldi, A., Sola, D., & Stolz, E. (2016). Feasibility and usefulness of ultrasonography in idiopathic intracranial hypertension or secondary intracranial hypertension. BMC Neurology, 16, 85. https://doi.org/10.1186/s12883-016-0594-3
Lochner P, et al. Feasibility and Usefulness of Ultrasonography in Idiopathic Intracranial Hypertension or Secondary Intracranial Hypertension. BMC Neurol. 2016 Jun 2;16:85. PubMed PMID: 27250852.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Feasibility and usefulness of ultrasonography in idiopathic intracranial hypertension or secondary intracranial hypertension. AU - Lochner,Piergiorgio, AU - Brio,Francesco, AU - Zedde,Maria Luisa, AU - Sanguigni,Sandro, AU - Coppo,Lorenzo, AU - Nardone,Raffaele, AU - Naldi,Andrea, AU - Sola,Daniele, AU - Stolz,Erwin, Y1 - 2016/06/02/ PY - 2016/01/06/received PY - 2016/05/11/accepted PY - 2016/6/3/entrez PY - 2016/6/3/pubmed PY - 2017/1/4/medline KW - Idiopathic intracranial hypertension KW - Optic nerve KW - Sonography SP - 85 EP - 85 JF - BMC neurology JO - BMC Neurol VL - 16 N2 - BACKGROUND: Transorbital sonography (TOS) has been proven to be able to non-invasively detect elevated intracranial pressure. In this condition TOS shows an increase in optic nerve sheath diameter (ONSD). It has been suggested that internal jugular vein valve insufficiency (IJVVI) may represent a factor contributing to the pathogenesis of idiopathic intracranial hypertension (IIH). The aim of this study was to investigate whether patients with IIH or secondary IH have higher ONSD values and higher frequency of IJVVI compared to subjects without IH. METHODS: Twenty-one patients with newly diagnosed IIH or secondary IH were prospectively evaluated and compared with 21 age, gender and BMI-matched controls. Experienced vascular sonographers used B-mode TOS to evaluate ONSD, optic nerve diameter (OND) and IJVVI. CSF opening pressures were also measured. RESULTS: ONSD values were significantly higher in patients (6.50 ± 0.67) than controls (5.73 ± 0.66; p < 0.0001). No differences were found in OND values between patients (2.99 ± 0.26) and controls (2.93 ± 0.41; p = 0.574). No correlation was demonstrated between ONSD and CSF opening pressure (r = 0,086) (p = 0.73). No difference in frequency of IJVVI between patients (11/42 valves, 26 %) and controls (9/42, 21 %) was observed (p = 0.777). CONCLUSIONS: Increased ONSD values detected by TOS support the diagnosis of IH. Our results do not support the hypothesis of a venous congestion as a potential factor contributing to the pathogenesis of IIH. TRIAL REGISTRATION: Not applicable. Observational, non-interventional study. SN - 1471-2377 UR - https://www.unboundmedicine.com/medline/citation/27250852/Feasibility_and_usefulness_of_ultrasonography_in_idiopathic_intracranial_hypertension_or_secondary_intracranial_hypertension_ L2 - https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-016-0594-3 DB - PRIME DP - Unbound Medicine ER -