• J Neuroimaging · Apr 2013

    Case Reports

    Sonographic assessment of the optic nerve sheath and transorbital monitoring of treatment effects in a patient with spontaneous intracranial hypotension: case report.

    • Jochen Bäuerle, Elke R Gizewski, Kerstin von Stockhausen, Bernhard Rosengarten, Martin Berghoff, Astrid E Grams, Manfred Kaps, and Max Nedelmann.
    • Department of Neurology, Justus-Liebig-University, Giessen, Germany. jochenbaeuerle@gmx.de
    • J Neuroimaging. 2013 Apr 1;23(2):237-9.

    ObjectiveTo investigate the potential of the ultrasound-based evaluation of the optic nerve sheath in a patient with spontaneous intracranial hypotension due to cervical cerebrospinal fluid (CSF) leakage.MethodsRepeated measurements of the optic nerve sheath diameter (ONSD) using B-mode sonography were performed before treatment initiation, during medical treatment, and during a course of repeated placement of epidural blood patches.ResultsOn admission, transorbital sonography revealed a decreased ONSD of 4.1 mm on the right and 4.3 mm on the left side. After 8 months of treatment with caffeine and computed tomography-guided epidural blood patches a gradual distension of the ONSD into the normal range was bilaterally observed (right: 5.2 mm; left: 5.3 mm).ConclusionsThe ultrasound-based evaluation of the optic nerve sheath may be helpful in detecting CSF hypovolemia and for determination of treatment effects. This report should be seen as a basis for future investigations on the sonographic assessment of the optic nerve sheath in diagnosis and treatment of intracranial hypotension.Copyright © 2011 by the American Society of Neuroimaging.

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