Ultrasound measurement of optic nerve sheath diameter pre- and post-lumbar puncture
Abstract Background To test the hypothesis that optic nerve sheath diameter (ONSD) correlates with real-time changes in intracranial pressure, we performed ultrasound measurements of the ONSD in ambulatory patients undergoing elective lumbar puncture (LP). We conducted a prospective cohort study, in...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-05-01
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| Series: | The Ultrasound Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s13089-020-00173-8 |
| _version_ | 1818910887661010944 |
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| author | Christopher K. Schott Mohammad I. Hirzallah Rock Heyman Daniel N. Lesky Emily B. Brant Clifton W. Callaway |
| author_facet | Christopher K. Schott Mohammad I. Hirzallah Rock Heyman Daniel N. Lesky Emily B. Brant Clifton W. Callaway |
| author_sort | Christopher K. Schott |
| collection | DOAJ |
| description | Abstract Background To test the hypothesis that optic nerve sheath diameter (ONSD) correlates with real-time changes in intracranial pressure, we performed ultrasound measurements of the ONSD in ambulatory patients undergoing elective lumbar puncture (LP). We conducted a prospective cohort study, including adult patients undergoing LP in a non-emergent setting. We measured ONSD perpendicular to the optic nerve at 3 mm behind the globe in both eyes in the traverse and sagittal planes, with the patient supine. The primary outcome was change in ONSD from pre-LP to post-LP. We calculated association of opening and closing LP pressures with changes in the pre- and post-LP ONSD measurements. Results The mean patient age was 49.0 years (SD = 37–61, range 19–67) with 21 females (72.4%) and 26 (89.7%) white American (not Hispanic or Latino). The average opening pressure and closing pressures were 20.4 cm and 13.5 cm with a difference of 6.9 cm, (95% CI 3.9–10.0 cm). Pressures between the participants with baseline ONSD measurement > 5 mm (average opening pressure = 21.3 cm) to those < 5 mm (20.2 cm) differed by 1.1 cm (95% CI − 5.7 to 8.0). Linear regression revealed no association between the sagittal, transverse, average, and change in ONSD measurements with the observed LP opening pressure, change in LP pressure, or volume of cerebral spinal fluid (CSF) drained. Conclusions In this study of ambulatory patients undergoing rapid decreases in ICP via elective LP, we detected no acute changes in ultrasonographic measurement of the ONSD. |
| first_indexed | 2024-12-19T22:49:57Z |
| format | Article |
| id | doaj.art-f22aec910f694d5898a378550ee6c235 |
| institution | Directory Open Access Journal |
| issn | 2524-8987 |
| language | English |
| last_indexed | 2024-12-19T22:49:57Z |
| publishDate | 2020-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Ultrasound Journal |
| spelling | doaj.art-f22aec910f694d5898a378550ee6c2352022-12-21T20:02:52ZengSpringerOpenThe Ultrasound Journal2524-89872020-05-011211810.1186/s13089-020-00173-8Ultrasound measurement of optic nerve sheath diameter pre- and post-lumbar punctureChristopher K. Schott0Mohammad I. Hirzallah1Rock Heyman2Daniel N. Lesky3Emily B. Brant4Clifton W. Callaway5VA Pittsburgh Health Care Systems * Critical Care Service Line (124U)University of Pittsburgh Multidisciplinary Critical Care Training ProgramDepartment of Neurology, University of Pittsburgh, and University of Pittsburgh Medical Center (UPMC)School of Medicine 401 Scaife Hall, University of PittsburghUniversity of Pittsburgh Multidisciplinary Critical Care Training ProgramDepartment of Emergency Medicine, University of Pittsburgh, and University of Pittsburgh, Medical Center (UPMC)Abstract Background To test the hypothesis that optic nerve sheath diameter (ONSD) correlates with real-time changes in intracranial pressure, we performed ultrasound measurements of the ONSD in ambulatory patients undergoing elective lumbar puncture (LP). We conducted a prospective cohort study, including adult patients undergoing LP in a non-emergent setting. We measured ONSD perpendicular to the optic nerve at 3 mm behind the globe in both eyes in the traverse and sagittal planes, with the patient supine. The primary outcome was change in ONSD from pre-LP to post-LP. We calculated association of opening and closing LP pressures with changes in the pre- and post-LP ONSD measurements. Results The mean patient age was 49.0 years (SD = 37–61, range 19–67) with 21 females (72.4%) and 26 (89.7%) white American (not Hispanic or Latino). The average opening pressure and closing pressures were 20.4 cm and 13.5 cm with a difference of 6.9 cm, (95% CI 3.9–10.0 cm). Pressures between the participants with baseline ONSD measurement > 5 mm (average opening pressure = 21.3 cm) to those < 5 mm (20.2 cm) differed by 1.1 cm (95% CI − 5.7 to 8.0). Linear regression revealed no association between the sagittal, transverse, average, and change in ONSD measurements with the observed LP opening pressure, change in LP pressure, or volume of cerebral spinal fluid (CSF) drained. Conclusions In this study of ambulatory patients undergoing rapid decreases in ICP via elective LP, we detected no acute changes in ultrasonographic measurement of the ONSD.http://link.springer.com/article/10.1186/s13089-020-00173-8Optic nerve sheath diameterIntracranial pressureUltrasound |
| spellingShingle | Christopher K. Schott Mohammad I. Hirzallah Rock Heyman Daniel N. Lesky Emily B. Brant Clifton W. Callaway Ultrasound measurement of optic nerve sheath diameter pre- and post-lumbar puncture The Ultrasound Journal Optic nerve sheath diameter Intracranial pressure Ultrasound |
| title | Ultrasound measurement of optic nerve sheath diameter pre- and post-lumbar puncture |
| title_full | Ultrasound measurement of optic nerve sheath diameter pre- and post-lumbar puncture |
| title_fullStr | Ultrasound measurement of optic nerve sheath diameter pre- and post-lumbar puncture |
| title_full_unstemmed | Ultrasound measurement of optic nerve sheath diameter pre- and post-lumbar puncture |
| title_short | Ultrasound measurement of optic nerve sheath diameter pre- and post-lumbar puncture |
| title_sort | ultrasound measurement of optic nerve sheath diameter pre and post lumbar puncture |
| topic | Optic nerve sheath diameter Intracranial pressure Ultrasound |
| url | http://link.springer.com/article/10.1186/s13089-020-00173-8 |
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