Sonographic assessment of the optic nerve sheath diameter in the diagnosis of idiopathic intracranial hypertension
| Autor: | Rafael García-Ruiz, Enrique Botia-Paniagua, Ángel Mateu-Mateu, Pablo del Saz-Saucedo, Olga Redondo-González, Rafael Huertas-Arroyo |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent business.operation Sensitivity and Specificity Spinal Puncture Likelihood ratios in diagnostic testing Young Adult 03 medical and health sciences 0302 clinical medicine Humans Medicine Prospective Studies Aged Ultrasonography Intracranial pressure Pseudotumor Cerebri medicine.diagnostic_test business.industry Lumbar puncture Ultrasound Neurointensive care Optic Nerve 030208 emergency & critical care medicine Organ Size Middle Aged medicine.disease Surgery Neurology Optic nerve Anterior ischemic optic neuropathy Female Neurology (clinical) Radiology business Transorbital 030217 neurology & neurosurgery |
| Zdroj: | Journal of the Neurological Sciences. 361:122-127 |
| ISSN: | 0022-510X |
| DOI: | 10.1016/j.jns.2015.12.032 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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