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P.A. Gonzalez, G. Dutton, I. Bryce; Ultrasonic Measurement of Optic Nerve Sheath Diameter in the Management of Benign Intracranial Hypertension . Invest. Ophthalmol. Vis. Sci. 2003;44(13):611.
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Purpose: Diagnosis of raised intracranial pressure (ICP) is essential to enable prompt, optimal treatment of benign intracranial hypertension (BIH). The optic nerve sheath diameter (ONSD) is increased when ICP is elevated and there has been recent interest in the use of ultrasound to diagnose and indirectly monitor elevated ICP by ONSD measurement. The advantage of the technique is its non-invasiveness, wide availability, portability, low cost and absence of ionizing radiation. This prospective study was designed to establish the range of normal values for adults (aged 16 and older). Methods: Seventy adults were recruited into the study. Exclusions included previous optic nerve or intracranial disease. Three B-mode scans were taken showing the optic nerve (10Mz probe). Measurements of the ONSD were taken 3 mm behind the optic nerve head. Results: ONSD measurement ranged from 3.7mm to 5.5mm, with no difference between males and females. Adults attending a BIH clinic will subsequently be recruited. The same method will be used to assess the optic nerve sheath diameter prior to, one hour and three hours after lumbar puncture assessment of ICP. Conclusions: ONSD changes significantly with raised ICP and can be measured by ultrasound. It may be possible to use ultrasound measurement of ONSD in the management of BIH rather than opening pressures of lumbar puncture thus saving patients repeated trauma and risk of infection.
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