Neurosonology

Feasibility and usefulness of ultrasonography in idiopathic intracranial hypertension or secondary intracranial hypertension

Lochner et al. reported on the diagnostic applicability of ultrasonography in idiopathic intracranial hypertension (IH) or secondary intracranial hypertension. The authors aimed to investigate, whether patients with intracranial IH or secondary IH have higher optic nerve sheath diameter (ONSD) values and higher frequency of internal jugular vein valve insufficiency (IJVVI) compared to subjects without IH. 

Lochner P, Brio F, Zedde ML, Sanguigni S, Coppo L, Nardone R, Naldi A, Sola D, Stolz E

BMC Neurol. 2016 Jun 2;16(1):85

http://www.ncbi.nlm.nih.gov/pubmed/27250852

Lochner et al. reported on the diagnostic applicability of ultrasonography in idiopathic intracranial hypertension (IH) or secondary intracranial hypertension. The authors aimed to investigate, whether patients with intracranial IH or secondary IH have higher optic nerve sheath diameter (ONSD) values and higher frequency of internal jugular vein valve insufficiency (IJVVI) compared to subjects without IH.

Twenty-one patients with newly diagnosed IIH or secondary IH were prospectively evaluated and compared with 21 age, gender and BMI-matched controls. The results of the study showed, that ONSD values were significantly higher in patients (6.50 ± 0.67) than controls (5.73 ± 0.66; P< 0.0001), while no differences were found in OND values between patients and controls. Interestingly, no correlation was demonstrated between ONSD and CSF opening pressure (r = 0.086) (P=0.73) and no difference in frequency of IJVVI between patients (11/42 valves, 26 %) and controls (9/42, 21 %) was observed (P = 0.777).

This study highlights the possible diagnostic role of ultrasonography in intracranial hypertension. According to the author’s conclusions, it seems that increased ONSD values detected by TOS support the diagnosis of IH, while no findings supporting the hypothesis of a venous congestion as a potential factor contributing to the pathogenesis of intracranial IH were documented.