Optic Nerve Sheath Diameter Used as Ultrasonographic Assessment of the Incidence of Raised Intracranial Pressure in Preeclampsia
- 1 May 2012
- journal article
- critical care-medicine
- Published by Ovid Technologies (Wolters Kluwer Health) in Anesthesiology
- Vol. 116 (5), 1066-1071
- https://doi.org/10.1097/aln.0b013e318246ea1a
Abstract
Background In some cases of severe preeclampsia/eclampsia, brain imaging displays signs compatible with raised intracranial pressure. We aimed to estimate the incidence of raised intracranial pressure in preeclampsia using ocular ultrasonography. Methods Optic nerve sheath diameter (ONSD) measurements were compared in 26 preeclamptic and 25 healthy pregnant women. For each optic nerve, two measurements were made (transverse plane and sagittal plane) using a 7.5 MHz ultrasound linear probe. Preeclamptic patients were followed-up until postpartum day 7. Results Median ONSD values were significantly greater in preeclamptic patients compared with healthy pregnant women at delivery (5.4 mm (95% CI: 5.2, 5.7) vs. 4.5 mm (95% CI: 4.3, 4.8), P < 0.0001). At delivery, 5/26 (19%) of preeclamptic patients had ONSD values above 5.8 mm (value associated in the literature with 95% risk of raised intracranial pressure) whereas none of the healthy pregnant group had such high ONSD values. In the preeclamptic group, ONSD decreased after the third postpartum day. ONSD values at day 7 were not significantly different from those obtained in the normal pregnancy group (P = 0.10). Conclusion In about 20% of preeclamptic patients, ONSD reaches values compatible with intracranial pressure above 20 mmHg. Further work is needed to confirm this incidence and to better understand the diagnostic and therapeutic usefulness of this easy-to-do monitoring technique.Keywords
This publication has 24 references indexed in Scilit:
- Systematic review of reversible cerebral vasoconstriction syndromeExpert Review of Cardiovascular Therapy, 2010
- Posterior Reversible Encephalopathy Syndrome: Associated Clinical and Radiologic FindingsMayo Clinic Proceedings, 2010
- Reversible cerebral vasoconstriction syndromePractical Neurology, 2009
- Posterior Reversible Encephalopathy Syndrome, Part 2: Controversies Surrounding Pathophysiology of Vasogenic EdemaAmerican Journal Of Neuroradiology, 2008
- Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical FeaturesAmerican Journal Of Neuroradiology, 2008
- Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injuryIntensive Care Medicine, 2007
- Monitoring the injured brain: ICP and CBFBritish Journal of Anaesthesia, 2006
- Maternal and perinatal outcome in pregnancies complicated with hypertensive disorder of pregnancy: a seven year experience of a tertiary care centerArchiv für Gynäkologie, 2005
- Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: ultrasound findings during intrathecal infusion testsJournal of Neurosurgery, 1997
- A Reversible Posterior Leukoencephalopathy SyndromeNew England Journal of Medicine, 1996