OBJECTIVE: To investigate the potential of the ultrasound-based evaluation of the optic nerve sheath in a patient with spontaneous intracranial hypotension due to cervical cerebrospinal fluid (CSF) leakage. METHODS: Repeated measurements of the optic nerve sheath diameter (ONSD) using B-mode sonography were performed before treatment initiation, during medical treatment, and during a course of repeated placement of epidural blood patches. RESULTS: On admission, transorbital sonography revealed a decreased ONSD of 4.1 mm on the right and 4.3 mm on the left side. After 8 months of treatment with caffeine and computed tomography-guided epidural blood patches a gradual distension of the ONSD into the normal range was bilaterally observed (right: 5.2 mm; left: 5.3 mm). CONCLUSIONS: The ultrasound-based evaluation of the optic nerve sheath may be helpful in detecting CSF hypovolemia and for determination of treatment effects. This report should be seen as a basis for future investigations on the sonographic assessment of the optic nerve sheath in diagnosis and treatment of intracranial hypotension.
OBJECTIVE: To investigate the potential of the ultrasound-based evaluation of the optic nerve sheath in a patient with spontaneous intracranial hypotension due to cervical cerebrospinal fluid (CSF) leakage. METHODS: Repeated measurements of the optic nerve sheath diameter (ONSD) using B-mode sonography were performed before treatment initiation, during medical treatment, and during a course of repeated placement of epidural blood patches. RESULTS: On admission, transorbital sonography revealed a decreased ONSD of 4.1 mm on the right and 4.3 mm on the left side. After 8 months of treatment with caffeine and computed tomography-guided epidural blood patches a gradual distension of the ONSD into the normal range was bilaterally observed (right: 5.2 mm; left: 5.3 mm). CONCLUSIONS: The ultrasound-based evaluation of the optic nerve sheath may be helpful in detecting CSF hypovolemia and for determination of treatment effects. This report should be seen as a basis for future investigations on the sonographic assessment of the optic nerve sheath in diagnosis and treatment of intracranial hypotension.
Authors: Marc Steinborn; Melanie Friedmann; Christine Makowski; Helmut Hahn; Alexander Hapfelmeier; Hendrik Juenger Journal: Childs Nerv Syst Date: 2016-01-13 Impact factor: 1.475
Authors: Jens Fichtner; Christian T Ulrich; Christian Fung; Christin Knüppel; Martina Veitweber; Astrid Jilch; Philippe Schucht; Michael Ertl; Beate Schömig; Jan Gralla; Werner J Z'Graggen; Corrado Bernasconi; Heinrich P Mattle; Felix Schlachetzki; Andreas Raabe; Jürgen Beck Journal: J Neurol Neurosurg Psychiatry Date: 2015-08-18 Impact factor: 10.154