Department of Neurology, University Medical Center Freiburg, Germany.
Department of Neuroradiology, University Medical Center Freiburg, Germany.
J Neuroimaging. 2016 Mar-Apr;26(2):194-6. doi: 10.1111/jon.12287. Epub 2015 Aug 17.
This study investigates the diagnostic value of optic nerve sheath diameter (ONSD) assessed by transorbital sonography for estimation of intracranial pressure (ICP) in patients with aneurysmal subarachnoid hemorrhage (SAH).
Simultaneous measurements of the ONSD and ICP in 27 patients suffering from SAH and acute hydrocephalus after placement of an extraventricular drain.
Despite normal mean ICP values ONSD was significantly higher in patients with SAH compared with healthy volunteers and no relevant decline of ONSD over time could be identified. In addition, no correlation between ONSD and ICP was observed.
In patients with SAH and acute hydrocephalus after aneurysm rupture, the ONSD remains expanded after normalization of ICP. This is most likely due to an impaired retraction capability of the optic nerve sheath. This finding should be considered when using transorbital sonography in the neuromonitoring of aneurysmal SAH.
本研究通过经眶超声评估视神经鞘直径（ONSD），旨在探讨其在评估颅内压（ICP）方面对伴有颅内动脉瘤性蛛网膜下腔出血（SAH）的患者的诊断价值。
对 27 例伴有急性脑积水并放置脑室外引流的 SAH 患者进行 ONSD 和 ICP 的同步测量。
尽管平均 ICP 值正常，但 SAH 患者的 ONSD 明显高于健康志愿者，且未发现 ONSD 随时间的推移而显著下降。此外，ONSD 与 ICP 之间无相关性。
在伴有颅内动脉瘤破裂的 SAH 和急性脑积水的患者中，视神经鞘的 ONSD 在 ICP 正常化后仍保持扩张。这很可能是由于视神经鞘的回缩能力受损所致。在对伴有颅内动脉瘤性蛛网膜下腔出血的患者进行神经监测时，应考虑到这一发现。
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