Department of Neurology, Army Hospital (Research and Referral), New Delhi, India.
Department of Medicine, Military Hospital, Palampur, Himachal Pradesh, India.
Neurol India. 2019 May-Jun;67(3):772-776. doi: 10.4103/0028-3886.263231.
Intracranial pressure (ICP) can be raised in many neurological conditions and must be treated early to prevent poor clinical outcomes. To detect the rising ICP, it is important to measure it repeatedly using a tool that is noninvasive, safe, accurate, and portable with minimal inter- and intraobserver variability. The aim of our study was to correlate cerebrospinal fluid (CSF) pressure with ultrasound (US)-measured optic nerve sheath diameter (ONSD) and find out a measurement which correlates best with CSF pressure of >20 cm of water.
All patients in whom lumbar puncture (LP) was indicated and CSF pressure could be measured using manometer were included in the study. Ocular US was used to measure the ONSD.
A hundred patients were included in the study out of which 81% were males. The mean age was 60.5 years (±15.6) with a range of 26-90 years. Significant positive correlation was found between the ONSD and CSF pressure. Correlation coefficient (r) was 0.715 (P < 0.001). Receiver's operating characteristic curve was used to find out the ONSD value correlating with a CSF pressure of >20 cm of water. An ONSD >0.63 cm had a sensitivity of 77.3% [95% confidence interval (CI) 54.6-92.1] and specificity of 92.3% (95% CI 84.0-97.1) in predicting a CSF pressure of >20 cm of water (likelihood ratio [LR] + 10.05, LR - 0.25).
There is a positive correlation of US-measured ONSD and LP-measured CSF pressure. ONSD of >0.63 cm suggests a CSF pressure of >20 cm of water.
颅内压 (ICP) 可在多种神经状况下升高，必须及早治疗以防止临床预后不良。为了检测不断升高的 ICP，使用一种非侵入性、安全、准确且便携的工具进行多次测量非常重要，其测量结果还需具有最小的观察者间和观察者内变异性。本研究的目的是探讨脑脊髓液 (CSF) 压力与超声 (US) 测量的视神经鞘直径 (ONSD) 的相关性，并找出与 CSF 压力>20cmH2O 相关性最佳的测量方法。
所有需要进行腰椎穿刺 (LP) 且可使用压力计测量 CSF 压力的患者均纳入本研究。使用眼部超声测量 ONSD。
本研究共纳入 100 例患者，其中 81%为男性。患者的平均年龄为 60.5 岁（±15.6），年龄范围为 26-90 岁。ONSD 与 CSF 压力之间存在显著正相关。相关系数 (r) 为 0.715（P<0.001）。使用受试者工作特征曲线来找出与 CSF 压力>20cmH2O 相关的 ONSD 值。当 ONSD>0.63cm 时，其对 CSF 压力>20cmH2O 的预测具有 77.3%的灵敏度（95%置信区间 [CI] 54.6-92.1）和 92.3%的特异性（95%CI 84.0-97.1）（似然比 [LR]+10.05，LR-0.25）。
US 测量的 ONSD 与 LP 测量的 CSF 压力之间存在正相关。当 ONSD>0.63cm 时，提示 CSF 压力>20cmH2O。
