Intracranial pressure following optic nerve decompression for benign intracranial hypertension

1981 ◽  
Vol 55 (3) ◽  
pp. 453-456 ◽  
Author(s):  
Andrew H. Kaye ◽  
J. E. K. Galbraith ◽  
John King
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Continuous Recording ◽  
Optic Nerve Sheath ◽  
Benign Intracranial Hypertension ◽  
Content Type ◽  
Nerve Sheath ◽  
Before And After ◽  
Fine Print

✓ The authors report the case of a patient with benign intracranial hypertension and severe papilledema, who underwent surgery for bilateral optic nerve sheath decompression. No change in the intracranial pressure (ICP) was seen during continuous recording performed before and after the operation. This case supports the contention that the decrease in papilledema and the visual improvements seen following this operation are more likely to be due to decrease in optic nerve sheath pressure than to a generalized decrease in ICP, as suggested by other authors.

Intraocular and optic nerve sheath hemorrhage in cases of sudden intracranial hypertension

1974 ◽  
Vol 41 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Paul J. Muller ◽  
John H. N. Deck
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Venous Hypertension ◽  
Optic Nerve Sheath ◽  
Consistent Finding ◽  
Content Type ◽  
Nerve Sheath ◽  
Intraocular Hemorrhage ◽  
Central Retinal Vein ◽  
Fine Print

✓ The eyes of 23 patients with sudden intracranial hypertension were studied at post-mortem. Intraocular hemorrhage had occurred in 37% and optic nerve sheath hemorrhage in 87%. Expansion of the optic nerve sheath, particularly the fusiform retrobulbar portion, was a consistent finding. The subdural space of the optic nerve sheath bore the brunt of the hemorrhage which sometimes communicated with perivascular intradural hemorrhages. Optic nerve sheath hemorrhage is shown to result from rupture of dural and bridging vessels of the optic nerve sheath; this we conclude is subsequent to optic nerve sheath dilatation caused by the transmission of intracranial pressure through the subarachnoid communication between the optic nerve sheath and the intracranial cavity. Intraocular hemorrhage is the result of retinal venous hypertension and rupture brought on by obstruction of both the central retinal vein and the retinochoroidal anastomosis.

The MRI appearance of the optic nerve sheath following fenestration for benign intracranial hypertension

1998 ◽  
Vol 8 (7) ◽  
pp. 1193-1196 ◽  
Author(s):  
D. Sallomi ◽  
H. Taylor ◽  
J. Hibbert ◽  
M. D. Sanders ◽  
D. J. Spalton ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Optic Nerve Sheath ◽  
Benign Intracranial Hypertension ◽  
Nerve Sheath

Surgical management of meningiomas involving the optic nerve sheath

2004 ◽  
Vol 101 (6) ◽  
pp. 951-959 ◽  
Author(s):  
Uta Schick ◽  
Uwe Dott ◽  
Werner Hassler
Keyword(s):  
Optic Nerve ◽  
Postoperative Radiotherapy ◽  
Visual Outcome ◽  
Tumor Location ◽  
Optic Nerve Sheath ◽  
Optic Canal ◽  
Content Type ◽  
Nerve Sheath ◽  
Fine Print

Object. The management of optic nerve sheath meningiomas (ONSMs) remains controversial but includes surgery, radiotherapy, and plain observation. Surgery is often thought to result in postoperative blindness. The authors report on a large series of patients surgically treated for ONSM, with an emphasis on the visual outcome. Methods. Seventy-three patients with ONSMs who had undergone surgery between 1991 and 2002 were retrospectively analyzed. The standard surgical approach consisted of pterional craniotomy, intradural (54 patients) or extradural (10 patients) unroofing of the optic canal, or a combined procedure (seven patients). Thirty-two tumors demonstrated extension through the optic canal. Twenty-nine tumors reached the chiasm or contralateral side. Patients with intraorbital flat tumors should undergo radiotherapy instead of surgery. Those with a large intraorbital mass and no useful vision should undergo surgery. Tumors extending intracranially through the optic canal are amenable to decompression of the optic canal and resection of the intracranial portion. The follow-up period was a mean 45.4 months (range 6–144 months). Ten patients underwent postoperative radiotherapy. Visual acuity was not significantly influenced by surgery but did become worse with a longer duration of preoperative symptoms and a longer follow-up period. A tumor location in the optic canal was another negative factor. Radiotherapy preserved vision in five of 10 cases. Conclusions. The loss of vision in patients with ONSM is only a matter of time. In patients with good vision the role of radiotherapy becomes more important. Surgery is recommended for intracranial tumors to prevent contralateral extension.

scholarly journals Optic Nerve Sheath Diameter Ultrasound Evaluation in Intensive Care Unit: Possible Role and Clinical Aspects in Neurological Critical Patients’ Daily Monitoring

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
M. Toscano ◽  
G. Spadetta ◽  
P. Pulitano ◽  
M. Rocco ◽  
V. Di Piero ◽  
...  
Keyword(s):  
Intensive Care ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Neurological Diseases ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Daily Monitoring ◽  
Nerve Sheath ◽  
Critical Patients

Background. The increase of the optic nerve sheath diameter (ONSD) is a reliable, noninvasive sonographic marker of intracranial hypertension. Aim of the study was to demonstrate the efficacy of ONSD evaluation, when monitoring neurocritical patients, to early identify malignant intracranial hypertension in patients with brain death (BD).Methods. Data from ultrasound ONSD evaluation have been retrospectively analyzed in 21 sedated critical patients with neurological diseases who, during their clinical course, developed BD. 31 nonneurological controls were used for standard ONSD reference.Results. Patients with neurological diseases, before BD, showed higher ONSD values than control group (CTRL: RT0.45±0.03 cm; LT0.45±0.02 cm; pre-BD: RT0.54±0.02 cm; LT0.55±0.02 cm;p<0.000) even without intracranial hypertension, evaluated with invasive monitoring. ONSD was further significantly markedly increased in respect to the pre-BD evaluation in neurocritical patients after BD, with mean values above 0.7 cm (RT0.7±0.02 cm; LT0.71±0.02 cm;p<0.000), with a corresponding dramatic raise in intracranial pressure. Logistic regression analysis showed a strong correlation between ONSD and ICP (R0,895,p<0.001).Conclusions. ONSD is a reliable marker of intracranial hypertension, easy to be performed with a minimal training. Routine ONSD daily monitoring could be of help in Intensive Care Units when invasive intracranial pressure monitoring is not available, to early recognize intracranial hypertension and to suspect BD in neurocritical patients.

scholarly journals Estimation of intracranial pressure by ultrasound of the optic nerve sheath in an animal model of intracranial hypertension

2021 ◽  
Vol 86 ◽  
pp. 174-179
Author(s):  
Brasil Chian Ping Jeng ◽  
Almir Ferreira de Andrade ◽  
Sérgio Brasil ◽  
Edson Bor-Seng-Shu ◽  
Alessandro Rodrigo Belon ◽  
...  
Keyword(s):  
Animal Model ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Optic Nerve Sheath ◽  
Nerve Sheath

scholarly journals Estimation of Intracranial Pressure by Ultrasound of the Optic Nerve Sheath in an Animal Model of Intracranial Hypertension

2020 ◽  
Author(s):  
Brasil Chian Jeng ◽  
Almir Ferreira de Andrade ◽  
Sérgio Brasil ◽  
Edson Bor-Seng-Shu ◽  
Alessandro Rodrigo Belon ◽  
...  
Keyword(s):  
Animal Model ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Optic Nerve Sheath Diameter ◽  
Saline Infusion ◽  
Optic Nerve Sheath ◽  
Balloon Inflation ◽  
Nerve Sheath ◽  
Baseline Levels

Abstract Background: Invasive monitoring of intracranial pressure (ICP) is currently the gold standard method for the safe diagnosis and treatment of intracranial hypertension (ICHy), but it is subject to hemorrhage, infection and malfunction. Ultrasound of the optic nerve sheath diameter (ONSD) has been applied as a non-invasive alternative that is cost effective and available at the bedside. However, ONSD time-lapse behavior in a set of ICHy and its relief by means of whether saline infusion or surgery is still unknown. The objective of this study was to correlate intracranial pressure and ultrasonography of the optic nerve sheath in an experimental animal model of ICHy, and the interval needed to ONSD to return to its baseline levels.Methods: An experimental study was conducted on 30 male and female pigs weighing about 20 kg. The diameter of the optic nerve sheath was evaluated by ultrasound at different measures of ICP given by intraventricular catheter and intracranial balloon inflation, saline infusion and balloon deflation. Laboratory and hemodynamic data were collected from the animals. ICP and ONSD values were correlated at each time point of the study.Results: All the variables obtained by ONSD ultrasonography as left optic nerve, right optic nerve and average of optic nerve sheath (AON) diameter were statistically significant to estimate ICP value. ONSD values changed immediately at balloon inflation, with a delay of 30 minutes average to return to baseline levels after balloon deflation (p = 0.016). No statistical significance was observed in ICP and ONSD values with hypertonic saline infusion. Correlation between ICP and ONSD was linear and can be estimated using the formula: -80.5 + 238.2 x AON, in this swine model. Conclusion: In the present study, ultrasound of optic nerve sheath diameter disclosed linear correlation with ICP, although a short delay in returning to its baseline levels may be observed in the case of sudden intracranial hypertension relief.

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