Cerebrospinal fluid and optic nerve sheath compartment syndrome: A common pathophysiological mechanism in five different cases?

2019 ◽  
Vol 48 (2) ◽  
pp. 212-219 ◽  
Author(s):  
Jie Hao ◽  
Achmed Pircher ◽  
Neil R. Miller ◽  
Jiemei Hsieh ◽  
Luca Remonda ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Optic Nerve ◽  
Compartment Syndrome ◽  
Optic Nerve Sheath ◽  
Pathophysiological Mechanism ◽  
Nerve Sheath

Optic Nerve Compartment Syndrome in a Patient with Optic Nerve Sheath Meningioma

2007 ◽  
Vol 17 (3) ◽  
pp. 454-458 ◽  
Author(s):  
G.P. Jaggi ◽  
A. Mironov ◽  
A.R. Huber ◽  
H.E. Killer
Keyword(s):  
Optic Nerve ◽  
Compartment Syndrome ◽  
Optic Nerve Sheath ◽  
Nerve Sheath ◽  
Optic Nerve Sheath Meningioma

Sonography of the optic nerve sheath diameter before and after microsurgical closure of a dural CSF fistula in patients with spontaneous intracranial hypotension – a consecutive cohort study

Cephalalgia ◽  
2018 ◽  
Vol 39 (2) ◽  
pp. 306-315 ◽  
Author(s):  
Jens Fichtner ◽  
Christian T Ulrich ◽  
Christian Fung ◽  
Debora Cipriani ◽  
Jan Gralla ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Optic Nerve ◽  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Cerebrospinal Fluid Leak ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Cerebrospinal Fluid Leakage ◽  
Nerve Sheath ◽  
Fluid Leak

Objective Spontaneous intracranial hypotension is caused by spinal cerebrospinal fluid leakage. Patients with orthostatic headaches and cerebrospinal fluid leakage show a decrease in optic nerve sheath diameter upon movement from supine to upright position. We hypothesized that the decrease in optic nerve sheath diameter upon gravitational challenge would cease after closure of the leak. Methods We included 29 patients with spontaneous intracranial hypotension and refractory symptoms admitted from 2013 to 2016. The systematic workup included: Optic nerve sheath diameter sonography, spinal MRI and dynamic myelography with subsequent CT. Microsurgical sealing of the cerebrospinal fluid leak was the aim in all cases. Results Of 29 patients with a proven cerebrospinal fluid leak, one declined surgery. A single patient was lost to follow-up. In 27 cases, the cerebrospinal fluid leak was successfully sealed by microsurgery. The width of the optic nerve sheath diameter in supine position increased from 5.08 ± 0.66 mm before to 5.36 ± 0.53 mm after surgery ( p = 0.03). Comparing the response of the optic nerve sheath diameter to gravitational challenge, there was a significant change from before (−0.36 ± 0.32 mm) to after surgery (0.00 ± 0.19 mm, p < 0.01). In parallel, spontaneous intracranial hypotension-related symptoms resolved in 26, decreased in one and persisted in a single patient despite recovery of gait. Conclusions The sonographic assessment of the optic nerve sheath diameter with gravitational challenge can distinguish open from closed spinal cerebrospinal fluid fistulas in spontaneous intracranial hypotension patients. A response to the gravitational challenge, that is, no more collapse of the optic nerve sheath while standing up, can be seen after successful treatment and correlates with the resolution of clinical symptoms. Sonography of the optic nerve sheath diameter may be utilized for non-invasive follow-up in spontaneous intracranial hypotension.

scholarly journals Relationship between the optic nerve sheath diameter and lumbar cerebrospinal fluid pressure in patients with normal tension glaucoma

Eye ◽  
2017 ◽  
Vol 31 (9) ◽  
pp. 1365-1372 ◽  
Author(s):  
A Pircher ◽  
M Montali ◽  
J Berberat ◽  
L Remonda ◽  
H E Killer
Keyword(s):  
Cerebrospinal Fluid ◽  
Optic Nerve ◽  
Fluid Pressure ◽  
Normal Tension Glaucoma ◽  
Optic Nerve Sheath Diameter ◽  
Cerebrospinal Fluid Pressure ◽  
Optic Nerve Sheath ◽  
Nerve Sheath ◽  
Lumbar Cerebrospinal Fluid

scholarly journals Spontaneous cerebrospinal fluid leak from the optic canal

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774828
Author(s):  
Kyle Hannabass ◽  
Jeb M Justice
Keyword(s):  
Cerebrospinal Fluid ◽  
Optic Nerve ◽  
Retrospective Chart Review ◽  
Cerebrospinal Fluid Leak ◽  
Optic Nerve Sheath ◽  
Anatomic Site ◽  
Endoscopic Closure ◽  
Nerve Sheath ◽  
Cerebrospinal Fluid Leaks ◽  
Fluid Leak

Objective: To present a case of successful repair of a spontaneous cerebrospinal fluid leak in a previously unreported anatomic site. Methods: Retrospective chart review. Results: A 48-year-old woman developed a spontaneous cerebrospinal fluid leak from the optic nerve sheath and underwent a multilayer endoscopic closure with no damage to the optic nerve. Conclusion: Endoscopic surgeons can successfully repair cerebrospinal fluid leaks from the optic nerve sheath without causing loss of vision.

scholarly journals Lower body negative pressure reduces optic nerve sheath diameter during head-down tilt

2017 ◽  
Vol 123 (5) ◽  
pp. 1139-1144 ◽  
Author(s):  
Karina Marshall-Goebel ◽  
Robert Terlević ◽  
Darius A. Gerlach ◽  
Simone Kuehn ◽  
Edwin Mulder ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Optic Nerve ◽  
Negative Pressure ◽  
Lower Body Negative Pressure ◽  
Ambient Air ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Fluid Distribution ◽  
Lower Body ◽  
Nerve Sheath

The microgravity ocular syndrome (MOS) results in significant structural and functional ophthalmic changes during 6-mo spaceflight missions consistent with an increase in cerebrospinal fluid (CSF) pressure compared with the preflight upright position. A ground-based study was performed to assess two of the major hypothesized contributors to MOS, headward fluid shifting and increased ambient CO2, on intracranial and periorbital CSF. In addition, lower body negative pressure (LBNP) was assessed as a countermeasure to headward fluid shifting. Nine healthy male subjects participated in a crossover design study with five head-down tilt (HDT) conditions: −6, −12, and −18° HDT, −12° HDT with −20 mmHg LBNP, and −12° HDT with a 1% CO2 environment, each for 5 h total. A three-dimensional volumetric scan of the cranium and transverse slices of the orbita were collected with MRI, and intracranial CSF volume and optic nerve sheath diameter (ONSD) were measured after 4.5 h HDT. ONSD increased during −6° ( P < 0.001), −12° ( P < 0.001), and −18° HDT ( P < 0.001) and intracranial CSF increased during −12° HDT ( P = 0.01) compared with supine baseline. Notably, LBNP was able to reduce the increases in ONSD and intracranial CSF during HDT. The addition of 1% CO2 during HDT, however, had no further effect on ONSD, but rather ONSD increased from baseline in a similar magnitude to −12° HDT with ambient air ( P = 0.001). These findings demonstrate the ability of LBNP, a technique that targets fluid distribution in the lower limbs, to directly influence CSF and may be a promising countermeasure to help reduce increases in CSF. NEW & NOTEWORTHY This is the first study to demonstrate the ability of lower body negative pressure to directly influence cerebrospinal fluid surrounding the optic nerve, indicating potential use as a countermeasure for increased cerebrospinal fluid on Earth or in space.

scholarly journals Lipocalin-type Prostaglandin D Synthase Concentration Gradients in the Cerebrospinal Fluid in Normal-tension Glaucoma Patients with Optic Nerve Sheath Compartmentation

Eye and Brain ◽  
2021 ◽  
Vol Volume 13 ◽  
pp. 89-97
Author(s):  
Achmed Pircher ◽  
Albert Neutzner ◽  
Margherita Montali ◽  
Andreas Huber ◽  
Hendrik PN Scholl ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Optic Nerve ◽  
Normal Tension Glaucoma ◽  
Optic Nerve Sheath ◽  
Concentration Gradients ◽  
Nerve Sheath ◽  
Prostaglandin D Synthase
Sign in / Sign up

Export Citation Format

Share Document