Optic Nerve Sonography in the Diagnostic Evaluation of Pseudopapilledema and Raised Intracranial Pressure: A Cross-Sectional Study

Mehrpour, Masoud; Torshizi, Fatemeh Oliaee; Esmaeeli, Shooka; Taghipour, Salameh; Abdollahi, Sahar

doi:10.1155/2015/146059

Cited by 24 publications

(16 citation statements)

References 12 publications

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“…In our study crescent sign was seen in 46/50 cases with a 92% sensitivity, which proves ultrasound B scan is a sensitive tool in initial diagnosis of papilledema. Sensitivity was 90%, 95% and 100% in studies by Neudorfer et al[ 3 ], Carter et al[ 4 ] and Mehrpour et al[ 5 ] respectively. However all these studies took a combination of measuring optic nerve width, 30° test and presence of crescent sign.…”

Section: Discussionmentioning

confidence: 99%

“…There are very few studies done which demonstrate the value of ocular ultrasonography in diagnosis of papilledema. Some studies have shown increased optic nerve sheath width by orbital ultrasonography correlating well with the final diagnosis of papilledema or pseudo papilledema[ 3 - 5 ]. However all these studies measured the optic nerve width ranging anywhere from 3 mm to 3.3 mm to 5.7 mm along with 30° test.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of crescent sign on ocular ultrasound in diagnosing papilledema

Bhosale

Shah

2017

WJM

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AIMTo study the usefulness of orbital ultrasonography in the diagnosis of papilledema.METHODSFifty patients who were referred to the neurophthalmology clinic and clinically suspected to have papilledema were selected. Thorough, clinical examination with slitlamp biomicroscopy and visual acuity assessment was done. These patients underwent ultrasonography to demonstrate the crescent sign. The patients were further evaluated with the neurologist and magnetic resonance imaging (MRI) thus confirming the diagnosis of papilledema. The results of our ultrasonographic evaluation were correlated with final diagnosis after thorough clinical evaluation, imaging and the neurologist’s opinion.RESULTSOut of 50 patients diagnosed having papilledema on MRI, 46 (92%) showed crescent sign on B scan ultrasonography. Headache was most common presenting complaint in 47 (94%) and idiopathic intracranial hypertension was most common underlying cause of papilledema in 30 (60%) cases.CONCLUSION“Crescent sign” seen on ultrasonography is a sensitive tool for diagnosis of papilledema. It is cost effective, less cumbersome and effective tool to differentiate between papilledema and pseudo papilledema before subjecting the patients to costly investigations like MRI. A positive crescent sign should always be followed by MRI to find out the cause of papilledema.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Accuracy of crescent sign on ocular ultrasound in diagnosing papilledema

Bhosale

Shah

2017

WJM

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“…The relationship between raised intracranial pressure and the dilatation of the ONS has been known for several years [15][16][17][18]. Also, it is known that NF-1 is associated with altered or worsened CSF circulation due to fibrotic changes of the arachnoid membranes [19].…”

Section: Discussionmentioning

confidence: 99%

Assessment of the visual pathways in patients with neurofibromatosis-1 by 3d-space technique at 3-tesla

2019

Turk J Med Sci

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Background/aim: We aimed to evaluate the size/tortuosity of the optic nerve (ON) and the dilatation of the ON sheath (ONS) in neurofibromatosis type 1 (NF-1) patients with 3T-MRI, and to assess the usefulness of 3D-SPACE in imaging the optic pathway, ON, and ONS in NF-1 patients. Materials and methods: Twenty consecutive NF-1 patients without optic pathway glioma (OPG) (Group 1), 16 consecutive NF-1 patients with OPG (Group 2), and 19 controls were included in this study. The thickness and tortuosity of the ON and the diameter of the ONS were measured on STIR and 3D-SPACE images. Results: The thickness of the ON was similar in all groups on STIR images (P>0.05). The mean ONS diameter was higher in Group 2 with this sequence (P=0.009). Controls had significantly lower grades of ON tortuosity than Groups 1 and 2 (P=0.001), and Group 1 had significantly lower ON tortuosity compared to Group 2 (P=0.001). Severe tortuosity was only detected in Group 2. Conclusion: ON tortuosity and ONS diameter were increased in NF-1 patients in the presence of OPG. High-resolution cranium imaging with the 3D-SPACE technique using 3T-MRI seems to be helpful for detection of the optic pathway morphology and pathologies in NF-1 patients.

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“…Another mechanism that may cause an increase in the ONSD could be that the ON, which is accepted as an extension of the brain, affects the ONSD with the effect of raised cranial perfusion pressure. In addition, it must be remembered that papillary edema, which is caused by ICP, may lead to increased ONSD (26,27). In some studies, ONSD has been reported as 4.9-5.9 mm in cases of ICP (17,20,30,31).…”

Section: Discussionmentioning

confidence: 99%

Bedside measurement of the optic nerve sheath diameterwith ultrasound in cerebrovascular disorders

Yüzbaşıoğlu¹,

Yüzbaşioğlu²,

Coskun³

et al. 2018

Turk J Med Sci

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Background/aim: We aimed to show the role of determination of optic nerve sheath diameter (ONSD) by bedside ultrasonography in an emergency department in the diagnosis of cerebrovascular disorders and its correlation with the clinical picture. Materials and methods:This prospective cross-sectional study included 55 patients with cerebrovascular disorders and 53 controls. Age, sex, ONSD, comorbid disease status, and multidetector computed tomography results of all subjects and application periods and National Institutes of Health Stroke Scale (NIHSS) scores of the patient group were evaluated. Results:The ONSD of the patient and control groups was determined as a median of 5.7 mm and 3.6 mm, respectively. The ONSD of the patient group was determined to be significantly higher than that of the control group (P < 0.05). A positive relationship was determined between NIHSS scores and ONSD values (P < 0.05). The specificity and sensitivity values were determined as 98.1% and 81.8%, respectively, for a cutoff value of 5 mm and as 100% and 72.7%, respectively, for a cutoff value of 6 mm. Conclusion:This study showed that bedside measurement of ONSD is an easy, cheap, and noninvasive method that can be used to support the diagnosis and evaluation of patients with acute stroke.

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Optic Nerve Sonography in the Diagnostic Evaluation of Pseudopapilledema and Raised Intracranial Pressure: A Cross-Sectional Study

Cited by 24 publications

References 12 publications

Accuracy of crescent sign on ocular ultrasound in diagnosing papilledema

Accuracy of crescent sign on ocular ultrasound in diagnosing papilledema

Assessment of the visual pathways in patients with neurofibromatosis-1 by 3d-space technique at 3-tesla

Bedside measurement of the optic nerve sheath diameterwith ultrasound in cerebrovascular disorders

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