Marc Steinborn1, Melanie Friedmann2, Christine Makowski3, Helmut Hahn2, Alexander Hapfelmeier4, Hendrik Juenger3. 1. Department of Pediatric Radiology, Staedtisches Klinikum Muenchen, Munich, Germany. steinborn@lrz.tum.de. 2. Department of Pediatric Radiology, Staedtisches Klinikum Muenchen, Munich, Germany. 3. Department for Paediatric and Adolescent Medicine, Schwabing Hospital, Munich, Germany. 4. Institute for Medical Statistics and Epidemiology, Technical University Munich, Munich, Germany.
Abstract
PURPOSE: To evaluate the accuracy of high resolution transbulbar sonography for the estimation of intracranial pressure (ICP) in children. METHODS: In children and adolescents with acute neurologic symptoms of various origin, transbulbar sonography was performed. Besides measurement of the optic nerve sheath diameter (ONSD), the ultrastructure of the subarachnoid space of the optic nerve sheath was evaluated. The results of transbulbar sonography were correlated with clinical data based on cross-sectional imaging, ICP measurement, and ophthalmologic examination. RESULTS: Eighty-one patients (age 3-17.8 years, mean 11.7 years) were included. In 25 children, cross-sectional imaging and ICP measurement revealed increased intracranial pressure. The mean ONSD was 6.85 ± 0.81 mm. Twenty patients (20/25, 80 %) had a microcystic appearance of the subarachnoid space of the optic nerve. In 56 children without evidence of increased intracranial pressure, the mean ONSD was 5.77 ± 0.48 mm. Forty-nine patients (49/56, 87.5 %) had a normal homogenous appearance of the subarachnoid space. The ONSD in children with increased intracranial pressure was significantly higher than in patients without (p < 0.001). CONCLUSION: High resolution transbulbar sonography of the optic nerve is a useful technique for the rapid and non-invasive estimation of intracranial pressure in children. Besides measurement of the optic nerve sheath diameter, evaluation of the ultrastructure of the subarachnoid space of the optic nerve is a helpful parameter.
PURPOSE: To evaluate the accuracy of high resolution transbulbar sonography for the estimation of intracranial pressure (ICP) in children. METHODS: In children and adolescents with acute neurologic symptoms of various origin, transbulbar sonography was performed. Besides measurement of the optic nerve sheath diameter (ONSD), the ultrastructure of the subarachnoid space of the optic nerve sheath was evaluated. The results of transbulbar sonography were correlated with clinical data based on cross-sectional imaging, ICP measurement, and ophthalmologic examination. RESULTS: Eighty-one patients (age 3-17.8 years, mean 11.7 years) were included. In 25 children, cross-sectional imaging and ICP measurement revealed increased intracranial pressure. The mean ONSD was 6.85 ± 0.81 mm. Twenty patients (20/25, 80 %) had a microcystic appearance of the subarachnoid space of the optic nerve. In 56 children without evidence of increased intracranial pressure, the mean ONSD was 5.77 ± 0.48 mm. Forty-nine patients (49/56, 87.5 %) had a normal homogenous appearance of the subarachnoid space. The ONSD in children with increased intracranial pressure was significantly higher than in patients without (p < 0.001). CONCLUSION: High resolution transbulbar sonography of the optic nerve is a useful technique for the rapid and non-invasive estimation of intracranial pressure in children. Besides measurement of the optic nerve sheath diameter, evaluation of the ultrastructure of the subarachnoid space of the optic nerve is a helpful parameter.
Authors: Jochen Bäuerle; Elke R Gizewski; Kerstin von Stockhausen; Bernhard Rosengarten; Martin Berghoff; Astrid E Grams; Manfred Kaps; Max Nedelmann Journal: J Neuroimaging Date: 2011-09-01 Impact factor: 2.486
Authors: M Steinborn; M Friedmann; H Hahn; A Hapfelmeier; E Macdonald; K Warncke; A Saleh Journal: Ultraschall Med Date: 2014-08-20 Impact factor: 6.548
Authors: Robert A Avery; Samir S Shah; Daniel J Licht; Jeffrey A Seiden; Jimmy W Huh; Jan Boswinkel; Michael D Ruppe; Amber Chew; Rakesh D Mistry; Grant T Liu Journal: N Engl J Med Date: 2010-08-26 Impact factor: 91.245
Authors: Susanne R Kerscher; Daniel Schöni; Felix Neunhoeffer; Markus Wolff; Karin Haas-Lude; Andrea Bevot; Martin U Schuhmann Journal: Childs Nerv Syst Date: 2019-08-08 Impact factor: 1.475
Authors: Susanne R Kerscher; Daniel Schöni; Helene Hurth; Felix Neunhoeffer; Karin Haas-Lude; Markus Wolff; Martin U Schuhmann Journal: Childs Nerv Syst Date: 2019-06-29 Impact factor: 1.475