B-Mode Transorbital Ultrasonography for the Diagnosis of Idiopathic Intracranial Hypertension: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 40 (02) ◽  
pp. 247-252 ◽  
Author(s):  
Piergiorgio Lochner ◽  
Klaus Fassbender ◽  
Sophia Knodel ◽  
Anika Andrejewski ◽  
Martin Lesmeister ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Optic Nerve Sheath Diameter ◽  
Cochrane Library ◽  
Nerve Sheath ◽  
Reporting Data ◽  
Transorbital Sonography

AbstractIn patients with idiopathic intracranial hypertension (IIH), transorbital sonography (TOS) may reveal an enlargement of the optic nerve sheath diameter (ONSD) and the presence of optic disc elevation (ODE), as a sign of an increase in intracranial pressure (ICP). We systematically reviewed the TOS findings in adults with IIH. MEDLINE, EMBASE, Cochrane Library and CENTRAL (1966 – May 2017) were searched to identify studies reporting data on patients with IIH assessed by B mode-TOS. Data were extracted and included in a meta-analysis, and the quality of the included studies was evaluated. 5 studies with 96 patients were included. The values of ODE were 0.8 – 1.2 mm and ONSD was 6.2 – 6.76 mm in IIH patients vs. 4.3 – 5.7 mm in controls. In IIH patients the ONSD was significantly higher compared to controls (overall weighted mean difference of 1.3 mm (95 % CI: 0.6 – 1.9 mm)). The meta-analysis of proportion of papilledema based on results of three studies revealed a pooled estimator of 87 % (95 % CI: 76 – 94 %). IIH patients have higher ONSD values and higher frequency of ODE compared to controls. The indirect, noninvasive ICP assessment using TOS may be useful in supporting the clinical diagnosis of IIH in adults by detecting increased ONSD values and the presence of ODE.

Stationary cycling exercise for knee osteoarthritis: A systematic review and meta-analysis

2020 ◽  
pp. 026921552097179
Author(s):  
Lijiang Luan ◽  
Jaquelin Bousie ◽  
Adrian Pranata ◽  
Roger Adams ◽  
Jia Han
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Sport Performance ◽  
Cochrane Library ◽  
Cycling Exercise ◽  
Random Effects Models

Objective: To evaluate effects of stationary cycling exercise on pain, function and stiffness in individuals with knee osteoarthritis. Data sources: Systematic search conducted in seven databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, PEDro, and CNKI) from inception to September 2020. Review methods: Included studies were randomized-controlled trials involving stationary cycling exercise conducted on individuals with knee osteoarthritis. End-trial weighted mean difference (WMD) and 95% confidence interval (CI) were analyzed, and random-effects models were used. Methodological quality and risk bias were assessed by using the Physiotherapy Evidence Database scale and Cochrane Collaboration tool, respectively. Results: Eleven studies with 724 participants were found, of which the final meta-analysis was performed with eight. Compared to a control (no exercise), stationary cycling exercise resulted in reduced pain (WMD 12.86, 95% CI 6.90–18.81) and improved sport performance (WMD 8.06, 95% CI 0.92–15.20); although most of the meta-analysis results were statistically significant, improvements in stiffness (WMD 11.47, 95% CI 4.69–18.25), function (WMD 8.28, 95% CI 2.44–14.11), symptoms (WMD 4.15, 95% CI −1.87 to 10.18), daily living (WMD 6.43, 95% CI 3.19 to 9.66) and quality of life (WMD 0.99, 95% CI −4.27 to 6.25) for individuals with knee osteoarthritis were not greater than the minimal clinically important difference values for each of these outcome measures. Conclusions: Stationary cycling exercise relieves pain and improves sport function in individuals with knee osteoarthritis, but may not be as clinically effective for improving stiffness, daily activity, and quality of life.

Sonographic assessment of the optic nerve sheath diameter in the diagnosis of idiopathic intracranial hypertension

2016 ◽  
Vol 361 ◽  
pp. 122-127 ◽  
Author(s):  
Pablo del Saz-Saucedo ◽  
Olga Redondo-González ◽  
Ángel Mateu-Mateu ◽  
Rafael Huertas-Arroyo ◽  
Rafael García-Ruiz ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Nerve Sheath ◽  
Sonographic Assessment

scholarly journals Idiopathic intracranial hypertension: a review of diagnosis and management

2021 ◽  
Vol 20 (4) ◽  
pp. 16-20
Author(s):  
Samuel Jeffery ◽  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Surgical Interventions ◽  
Optic Nerve Sheath Fenestration ◽  
Nerve Sheath ◽  
Prevalence Of Obesity ◽  
Csf Diversion ◽  
Disease Modifying ◽  
Disease Modifying Treatment

With the increasing prevalence of obesity, the incidence of idiopathic intracranial hypertension (IIH) is rising. Headache and threat to vision are the predominant features and the principal cause of morbidity and reduced quality of life. Identification of papilloedema must prompt urgent investigation to exclude any underlying cause and management should be multi-disciplinary, focusing on protecting vision and reducing headache burden. Weight loss is the most effective and only disease modifying treatment for IIH but surgical interventions may need to be considered in some patients. Whilst optic nerve sheath fenestration and CSF diversion have established roles in protecting vision, there is increasing interest in venous sinus stenting and bariatric surgery as additional interventions that may have efficacy in the treatment of this condition.

Neuroimaging Features of Intracranial Hypertension in Pediatric Patients With New-Onset Idiopathic Seizures, a Comparison With Patients with Confirmed Diagnosis of Idiopathic Intracranial Hypertension: A Preliminary Study

2021 ◽  
pp. 088307382110452
Author(s):  
Arash Kamali ◽  
Azin Aein ◽  
Niyousha Naderi ◽  
Sally J. Choi ◽  
Nathan Doyle ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Pediatric Patients ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Opening Pressure ◽  
Cutoff Value ◽  
Nerve Sheath ◽  
New Onset

Seizures have been reported in association with idiopathic intracranial hypertension in pediatric patients. Magnetic resonance imaging (MRI) signs of intracranial hypertension have not been investigated before in pediatric patients with new-onset idiopathic seizures. MRI scans of 182 pediatric patients were retrospectively analyzed for imaging findings of intracranial hypertension, including 46 patients with new-onset idiopathic seizures and elevated cerebrospinal fluid opening pressure, 40 patients with new-onset idiopathic seizures and normal opening pressure, 56 patients with confirmed idiopathic intracranial hypertension, and 40 age- and sex-matched controls. The optic nerve sheath diameter is significantly larger in the group with new-onset idiopathic seizures and elevated opening pressure (mean diameter of 6.02 ± 0.45 mm) compared to patients with new-onset idiopathic seizures and normal opening pressure (mean diameter of 5.24 ± 0.50 mm) ( P value <.001). The cutoff value of 6.0 mm for optic nerve sheath diameter showed 63% sensitivity and 88% specificity to differentiate pediatric patients with seizures and elevated opening pressure from those with seizures and normal opening pressure. Conclusion A cutoff value of 6.0 mm for optic nerve sheath dilation may be used as a screening imaging marker to suspect elevated opening pressure with specificity of 88% in pediatric patients with new-onset idiopathic seizures.

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