Ultrasound-guided initial diagnosis and follow-up of pediatric idiopathic intracranial hypertension
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Date
2024-03-20
Authors
Kerscher, Susanne Regina
Zipfel, Julian
Haas-Lude, Karin
Bevot, Andrea
Schuhmann, Martin Ulrich
Journal Title
Journal ISSN
Volume Title
Publication Type
Wissenschaftlicher Artikel
Published in
Pediatric Radiology, 2024
Abstract
Background
Idiopathic intracranial hypertension in children often presents with non-specific symptoms found in conditions such as hydrocephalus. For definite diagnosis, invasive intracranial pressure measurement is usually required. Ultrasound (US) of the optic nerve sheath diameter provides a non-invasive method to assess intracranial pressure. Transtemporal US allows imaging of the third ventricle and thus assessment for hydrocephalus.
Objective
To investigate whether the combination of US optic nerve sheath and third ventricle diameter can be used as a screening tool in pediatric idiopathic intracranial hypertension to indicate elevated intracranial pressure and exclude hydrocephalus as an underlying pathology. Further, to analyze whether both parameters can be used to monitor treatment outcome.
Materials and methods
We prospectively included 36 children with idiopathic intracranial hypertension and 32 controls. Using a 12-Mhz linear transducer and a 1–4-Mhz phased-array transducer, respectively, optic nerve sheath and third ventricle diameters were determined initially and during the course of treatment.
Results
In patients, the mean optic nerve sheath diameter was significantly larger (6.45±0.65 mm, controls: 4.96±0.32 mm) and the mean third ventricle diameter (1.69±0.65 mm, controls: 2.99±1.31 mm) was significantly smaller compared to the control group, P<0.001. Optimal cut-off values were 5.55 mm for the optic nerve sheath and 1.83 mm for the third ventricle diameter.
Conclusions
The combined use of US optic nerve sheath and third ventricle diameter is an ideal non-invasive screening tool in pediatric idiopathic intracranial hypertension to indicate elevated intracranial pressure while ruling out hydrocephalus. Treatment can effectively be monitored by repeated US, which also reliably indicates relapse.
Description
Faculties
Institutions
UKU. Klinik für diagnostische und interventionelle Radiologie
Citation
DFG Project uulm
EU Project THU
Other projects THU
License
CC BY 4.0 International
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DOI external
DOI external
10.1007/s00247-024-05905-9
Institutions
Periodical
Degree Program
DFG Project THU
item.page.thu.projectEU
item.page.thu.projectOther
Series
Keywords
Idiopathic intracranial hypertension, Non-invasive diagnosis, Optic nerve sheath diameter, Pediatric, Pseudotumor cerebri, Third ventricle diameter, Ultrasound, DDC 610 / Medicine & health