Ozturk Zeynep, Atalay Tuba, Arhan Ebru, Aydin Kursad, Serdaroglu Ayse, Hirfanoglu Tugba, Havali Cengiz, Akbas Yilmaz, Yalinbas Duygu
Faculty of Medicine, Department of Pediatric Neurology, Gazi University, 06510, Ankara, Besevler, Turkey.
Faculty of Medicine, Department of Ophthalmology, Gazi University, Ankara, Turkey.
Childs Nerv Syst. 2017 Sep;33(9):1501-1507. doi: 10.1007/s00381-017-3454-6. Epub 2017 May 22.
The goal of this study was to evaluate the utility of orbital ultrasonography and magnetic resonance imaging in the diagnosis of idiopathic intracranial hypertension (IIH).
We reviewed the medical records of patients referred to our department for suspected IIH.
Seven children were diagnosed with IIH. Nine children revealed pseudopapilledema by optic coherence tomography and/or orbital ultrasonography. When the axial sequences were reexamined, patients with papilledema had optic nerve sheath (ONS) enlargement (6.62 ± 0.70 mm); patients with pseudopapilledema had ONS diameter as 4.62 ± 0.64 mm. There was a significant correlation between the CSF opening pressure and ONS diameter (p < 0.005, r = 0.661). In the papilledema group, the presence of proposed subtle markers as increased tortuosity in the optic nerve was found in six patients. Five of seven patients had a target sign, intraocular protrusion of the optic nerve, and posterior globe flattening.
Ophthalmological review is important to avoid unnecessary procedures for detection of true papilledema. ONS diameter is a reliable neuroimaging marker as other subtle markers.
本研究的目的是评估眼眶超声检查和磁共振成像在特发性颅内高压（IIH）诊断中的效用。
我们回顾了因疑似IIH转诊至我科的患者的病历。
7名儿童被诊断为IIH。9名儿童经光学相干断层扫描和/或眼眶超声检查显示有假性视乳头水肿。重新检查轴位序列时，视乳头水肿患者的视神经鞘（ONS）增宽（6.62±0.70毫米）；假性视乳头水肿患者的ONS直径为4.62±0.64毫米。脑脊液开放压力与ONS直径之间存在显著相关性（p<0.005，r=0.661）。在视乳头水肿组中，6例患者发现存在如视神经迂曲增加等拟议的细微标志物。7例患者中有5例出现靶征、视神经眼球内突出和眼球后部扁平。
眼科检查对于避免检测真正视乳头水肿的不必要程序很重要。ONS直径与其他细微标志物一样，是一种可靠的神经影像学标志物。
