Comparison of Optic Nerve Sheath Diameters Measured by Optic Ultrasonography Before and After Lumbar Puncture in Idiopathic Intracranial Hypertension Patients

Küçük Resim Yok

Tarih

2023

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

Turkish Neuropsychiatric Society

Erişim Hakkı

info:eu-repo/semantics/openAccess

Özet

Introduction: Idiopathic intracranial hypertension (IIH) symptoms include headache, blurred vision, and papilledema which may lead to permanent vision loss unless diagnosed and treated. Definitive diagnosis of IIH usually requires the measurement of intracranial pressure (ICP) via lumbar puncture (LP) which is an invasive and unwanted technique for patients. In our study, optic nerve sheath diameters (ONSD) were measured before and after lumbar puncture in IIH patients and the relationship of these measurements with ICP changes was evaluated as well as the effect of decreasing cerebrospinal fluid (CSF) pressure after a lumbar puncture on ONSD. Thus, we want to investigate whether optic nerve ultrasonography (USG) is a useful tool instead of the invasive LP for the diagnosis of IIH. Methods: A total of 25 patients who applied to the neurology clinics of Ankara Numune Training and Research Hospital between May 2014 and December 2015 and were diagnosed with IIH were included in the study. The control group consisted of 22 individuals who applied with complaints other than headaches, visual impairment or tinnitus. Optic nerve sheath diameters were measured from both eyes before and after the LP. After pre-LP measurements were taken, opening and closing CSF pressure was measured. In the control group, ONSD was measured with optic USG. Results: Mean age of the IIH group and the control group was determined as 34.8±11.5 and 45.8±13.3 years, respectively. In the patient group, mean CSF opening pressure was 33.9±8.0 cm H2 O and mean closing pressure was 18.1±4.7 cm H2 O. Mean ONSD measured pre-LP was 7.1±1.0 mm in the right eye and 6.9±0.7 mm in the left eye, while mean post-LP ONSD was 6.7±0.9 mm in the right eye and 6.4±0.8 mm in the left eye. There was a statistically significant difference between ONSD values before and after the LP (p=0.006 for the right eye, p<0.001 for the left eye). In the control group, mean ONSD was 5.4±0.7 mm in the right eye and 5.5±0.6 mm in the left eye, and a statistically significant difference was found between ONSD values before and after the LP (p<0.001 for the right eye and left eye). A significant positive correlation was determined between left ONSD measurements before the LP and CSF opening pressure (r=0.501, p=0.011). Conclusions: In the present study, it was found that ONSD measurement by optic USG significantly displays increased ICP, and decreasing pressure via LP is rapidly reflecting ONSD measurement. Based on these findings, it is suggested that ONSD measurements by optic USG, a non-invasive method, can be used in the diagnosis and follow-up of IIH patients. © 2022 by Turkish Association of Neuropsychiatry

Açıklama

Anahtar Kelimeler

Idiopathic intracranial hypertension, increased intracranial pressure, lumbar puncture, optic nerve sheath diameter measurement, adult, aged, Article, body mass, bone dysplasia, cerebrospinal fluid pressure, cerebrovascular accident, clinical article, controlled study, dizziness, echography, female, follow up, headache, human, hypertensive patient, idiopathic intracranial hypertension, ischemic stroke, lumbar puncture, male, non invasive procedure, nuclear magnetic resonance imaging, optic nerve, optic nerve sheath diameter, thrombocytopenia, tinnitus, visual impairment

Kaynak

Noropsikiyatri Arsivi

WoS Q Değeri

Scopus Q Değeri

Q3

Cilt

60

Sayı

2

Künye