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Document type:
journal article 
Author(s):
Steinborn, Marc; Friedmann, Melanie; Makowski, Christine; Hahn, Helmut; Hapfelmeier, Alexander; Juenger, Hendrik 
Title:
High resolution transbulbar sonography in children with suspicion of increased intracranial pressure. 
Abstract:
To evaluate the accuracy of high resolution transbulbar sonography for the estimation of intracranial pressure (ICP) in children.In children and adolescents with acute neurologic symptoms of various origin, transbulbar sonography was performed. Besides measurement of the optic nerve sheath diameter (ONSD), the ultrastructure of the subarachnoid space of the optic nerve sheath was evaluated. The results of transbulbar sonography were correlated with clinical data based on cross-sectional imaging, ICP measurement, and ophthalmologic examination.Eighty-one patients (age 3-17.8 years, mean 11.7 years) were included. In 25 children, cross-sectional imaging and ICP measurement revealed increased intracranial pressure. The mean ONSD was 6.85 ± 0.81 mm. Twenty patients (20/25, 80 %) had a microcystic appearance of the subarachnoid space of the optic nerve. In 56 children without evidence of increased intracranial pressure, the mean ONSD was 5.77 ± 0.48 mm. Forty-nine patients (49/56, 87.5 %) had a normal homogenous appearance of the subarachnoid space. The ONSD in children with increased intracranial pressure was significantly higher than in patients without (p< 0.001).High resolution transbulbar sonography of the optic nerve is a useful technique for the rapid and non-invasive estimation of intracranial pressure in children. Besides measurement of the optic nerve sheath diameter, evaluation of the ultrastructure of the subarachnoid space of the optic nerve is a helpful parameter. 
Journal title abbreviation:
Childs Nerv Syst 
Year:
2016 
Journal volume:
32 
Journal issue:
Pages contribution:
655-60 
Language:
eng 
Print-ISSN:
0256-7040 
TUM Institution:
Kinderklinik und Poliklinik; Institut für Medizinische Statistik und Epidemiologie