Williams Peter
Western Health, Gordon Street, Footscray, VIC 3011, Australia.
Case Rep Crit Care. 2017;2017:3978934. doi: 10.1155/2017/3978934. Epub 2017 Apr 5.
A previously fit and healthy 26-year-old lady with no significant medical history presented with a two-month history of headaches. The headaches were prolonged, generalised, and unusually severe for the patient. Examination revealed papilloedema. The patient's optic nerve sheath diameter was measured 3 mm posterior to the globe and found to be 7.5 mm. The patient subsequently had computed tomography scan of her brain that showed an optic nerve sheath diameter of 7.56 mm as measured 3 mm posterior to the globe. After an obstructive lesion was ruled out on the computed tomography scan, a lumbar puncture was then performed and cerebrospinal fluid was drained. An ultrasound of the optic nerve sheath diameter was repeated showing a reduced diameter of 5.6 mm. The patient was admitted to the neurology unit and ultimately diagnosed with idiopathic intracranial hypertension. This case report highlights the potential of rapidly identifying elevated intracranial pressure using a noninvasive method.
一位既往健康、无重大病史的26岁女性，出现了为期两个月的头痛症状。这些头痛持续时间长、范围广泛，且对该患者来说异常严重。检查发现视乳头水肿。在眼球后方3毫米处测量患者的视神经鞘直径，结果为7.5毫米。该患者随后进行了脑部计算机断层扫描，显示在眼球后方3毫米处测量的视神经鞘直径为7.56毫米。在计算机断层扫描排除阻塞性病变后，接着进行了腰椎穿刺并引流脑脊液。重复进行视神经鞘直径超声检查，显示直径减小至5.6毫米。该患者被收入神经内科病房，最终被诊断为特发性颅内高压。本病例报告强调了使用非侵入性方法快速识别颅内压升高的可能性。
