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Optic nerve sonographic examination to predict raised intracranial pressure in idiopathic intracranial hypertension: The cut-off points.
Neuroradiol J. 2018 Oct; 31(5):490-495.NJ

Abstract

Purpose Monitoring of raised intracranial pressure (ICP) in patients with idiopathic intracranial hypertension (IIH) is required to prevent secondary optic nerve damage. Sonographic measurement of the optic nerve sheath diameter (ONSD) is a noninvasive method to evaluate intracranial hypertension. Different ONSD cut-off values have been reported probably due to ethnic variations. Our aim was to determine optic nerve sonographic examination cut-off points to predict raised ICP in IIH patients. Methods This case-control study was conducted on 99 IIH post-pubertal female patients (both probable and definite) and 35 age- and sex-matched healthy volunteers. Sonographic ONSD and optic nerve diameter (OND) were obtained 3 mm behind the posterior edge of the globe in a horizontal plane via a 7-13 MHz linear probe. Lumbar puncture was then carried out on the patients. Results The opening cerebrospinal fluid pressure documented in the patient group was 279.64 ± 65.97 mm H2O. A statistically significant difference was found between IIH patients and controls regarding ONSD. The best ONSD cut-off value indicating raised ICP was 6.05 mm with an area under the curve of 0.850 (95% confidence interval 0.805 to 0.894, 73.2% sensitivity and 91.4% specificity). Regarding OND/ONSD ratio, there was an insignificant difference between both groups. Conclusion Sonographic ONSD but not OND/ONSD ratio could offer a bedside adjunct or alternative indicator of elevated ICP in IIH patients. Ethnic differences, however, should be noted when using this parameter.

Authors+Show Affiliations

1 Neurology Department, Faculty of Medicine, Cairo University, Egypt.1 Neurology Department, Faculty of Medicine, Cairo University, Egypt.1 Neurology Department, Faculty of Medicine, Cairo University, Egypt.2 Ophthalmology Department, Faculty of Medicine, Cairo University, Egypt.3 Human physiology Department, Faculty of Medicine, Cairo University, Egypt.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30024291

Citation

Kishk, Nirmeen A., et al. "Optic Nerve Sonographic Examination to Predict Raised Intracranial Pressure in Idiopathic Intracranial Hypertension: the Cut-off Points." The Neuroradiology Journal, vol. 31, no. 5, 2018, pp. 490-495.
Kishk NA, Ebraheim AM, Ashour AS, et al. Optic nerve sonographic examination to predict raised intracranial pressure in idiopathic intracranial hypertension: The cut-off points. Neuroradiol J. 2018;31(5):490-495.
Kishk, N. A., Ebraheim, A. M., Ashour, A. S., Badr, N. M., & Eshra, M. A. (2018). Optic nerve sonographic examination to predict raised intracranial pressure in idiopathic intracranial hypertension: The cut-off points. The Neuroradiology Journal, 31(5), 490-495. https://doi.org/10.1177/1971400918789385
Kishk NA, et al. Optic Nerve Sonographic Examination to Predict Raised Intracranial Pressure in Idiopathic Intracranial Hypertension: the Cut-off Points. Neuroradiol J. 2018;31(5):490-495. PubMed PMID: 30024291.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optic nerve sonographic examination to predict raised intracranial pressure in idiopathic intracranial hypertension: The cut-off points. AU - Kishk,Nirmeen A, AU - Ebraheim,Asmaa M, AU - Ashour,Amal S, AU - Badr,Nashwa M, AU - Eshra,Mohamed A, Y1 - 2018/07/19/ PY - 2018/7/20/pubmed PY - 2018/11/6/medline PY - 2018/7/20/entrez KW - Optic nerve sonography KW - idiopathic intracranial hypertension KW - optic nerve sheath diameter SP - 490 EP - 495 JF - The neuroradiology journal JO - Neuroradiol J VL - 31 IS - 5 N2 - Purpose Monitoring of raised intracranial pressure (ICP) in patients with idiopathic intracranial hypertension (IIH) is required to prevent secondary optic nerve damage. Sonographic measurement of the optic nerve sheath diameter (ONSD) is a noninvasive method to evaluate intracranial hypertension. Different ONSD cut-off values have been reported probably due to ethnic variations. Our aim was to determine optic nerve sonographic examination cut-off points to predict raised ICP in IIH patients. Methods This case-control study was conducted on 99 IIH post-pubertal female patients (both probable and definite) and 35 age- and sex-matched healthy volunteers. Sonographic ONSD and optic nerve diameter (OND) were obtained 3 mm behind the posterior edge of the globe in a horizontal plane via a 7-13 MHz linear probe. Lumbar puncture was then carried out on the patients. Results The opening cerebrospinal fluid pressure documented in the patient group was 279.64 ± 65.97 mm H2O. A statistically significant difference was found between IIH patients and controls regarding ONSD. The best ONSD cut-off value indicating raised ICP was 6.05 mm with an area under the curve of 0.850 (95% confidence interval 0.805 to 0.894, 73.2% sensitivity and 91.4% specificity). Regarding OND/ONSD ratio, there was an insignificant difference between both groups. Conclusion Sonographic ONSD but not OND/ONSD ratio could offer a bedside adjunct or alternative indicator of elevated ICP in IIH patients. Ethnic differences, however, should be noted when using this parameter. SN - 2385-1996 UR - https://www.unboundmedicine.com/medline/citation/30024291/Optic_nerve_sonographic_examination_to_predict_raised_intracranial_pressure_in_idiopathic_intracranial_hypertension:_The_cut_off_points_ L2 - https://journals.sagepub.com/doi/10.1177/1971400918789385?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -