Measuring the optic nerve sheath diameter by using ultrasonography in diagnosis and follow-up of pseudo-tumor cerebri: A case report

Abstract

Introduction: The pseudo-tumor cerebri (PTC) is defined as the idiopathic or benign intracranial hypertension (IH), complaints of which cannot be explained in a different way. PTC is an exclusion diagnosis, in which the neuroophtalmopathology of IH cannot be determined. The patients with PTC may have complaints such as headache, nausea, vomiting, temporary blurred vision, and mild-level vision loss or unilateral or bilateral abducens nerve paralysis may develop. The radiological examination of patients yields normal results. In case that IH develops due to any reason, the enlargement is seen in optic nerve sheath diameter (ONSD) in the acute period. Case reports: 14 year-old patient, who has been diagnosed for PTC in our unit, optic nerve sheath diameter (ONSD) measurement and follow-up of pressure change of whom have been performed by using ultrasonography (USG) method, is presented in order to discuss the contribution of this non-invasive method to diagnosis, treatment, and observation processes. Conclusion: USG and ONSD measurement in PTC cases may be effective and reliable monitoring method as much as invasive methods. Keywords Pseudo-tumor Cerebri, Optic Nerve Sheath Diameter Measurement References * 1. Bekerman I, Sigal T, Kimiagar I, Almer ZE, Vaiman M. Diagnostic value of the optic nerve sheath diameter in pseudotumor cerebri. Journal of Clinical Neuroscience 2016; 30: 106-9. * 2. Salahuddin N, Mohamed A, Alharbi N, Ansari H, Khaled JZ, Marashly Q, et al. The incidence of increased ICP in ICU patients with non-traumatic coma as diagnosed by ONSD and CT: a prospective cohort study. BMC Anesthesiol. 2016; 16: 106. * 3. Friedmann DI, Jacobson DM. Diagnosis criteria for idiopathic intracranial hypertension. Neurology 2002; 59(95): 1492-5. * 4. Lochner P, Nardone R, Tezzeon F, Coppo L. Optic Nerve Sonography to Monitor Treatment Efficacy in Idiopathic Intracranial Hypertension: A Case Report. Journal of Neuroimaging 2013; 23: 533-4. * 5. Singleton J, Dagan A, Edlow JA, Hoffmann B. Real-time optic nerve sheath diameter reduction measured with bedside ultrasound after therapeutic lumbar puncture in a patient with idiopathic intracranial hypertension. American Journal of Emergency Medicine 2015; 33: 860.e5-7.