Zewdie Ayalew, Tesema Haymanot, Aklilu Abenezer Tirsit, Teklemariam Tsegazeab Laeke, Zewdu Tigist, Ashagre Yordanos, Bizuneh Yemsrach, Azazh Aklilu, Hassen Getaw Worku
Addis Ababa University, Tikur Anbessa Specialized Hospital, Department of Emergency Medicine, Ethiopia.
Addis Ababa University, Tikur Anbessa Specialized Hospital, Department of Neurosurgery, Ethiopia.
Afr J Emerg Med. 2016 Sep;6(3):e1-e4. doi: 10.1016/j.afjem.2016.06.002. Epub 2016 Jul 22.
Increased intracranial pressure is usually measured with invasive methods that are not practical in resource-limited countries. However, bedside ultrasound, a non-invasive method, measures the optic nerve sheath diameter and could be a safe and accurate alternative to measure intracranial pressure, even in children.
We report a case of a 15-year old patient who presented with severe headache, projectile vomiting, and neck pain for two months. The bedside ultrasound showed a 10 mm optic nerve sheath diameter and a Computed Tomography scan of her brain revealed obstructive hydrocephalus secondary to a mass in the fourth ventricle. After intervening, we were able to monitor the decrease in her optic nerve sheath diameter with ultrasound.
Performing invasive procedures continues to be a challenge in the resource limited setting. However, bedside ultrasound can be a useful tool in emergency centres for early detection and monitoring of intracranial pressure.
颅内压升高通常采用侵入性方法测量,而这种方法在资源有限的国家并不实用。然而,床旁超声作为一种非侵入性方法,可测量视神经鞘直径,甚至对于儿童而言,也可能是一种安全且准确的测量颅内压的替代方法。
我们报告一例15岁患者,其出现严重头痛、喷射性呕吐及颈部疼痛达两个月。床旁超声显示视神经鞘直径为10毫米,其脑部计算机断层扫描显示第四脑室肿物继发梗阻性脑积水。干预治疗后,我们能够通过超声监测其视神经鞘直径的减小情况。
在资源有限的环境中,进行侵入性操作仍然是一项挑战。然而,床旁超声在急诊中心可成为早期检测和监测颅内压的有用工具。