Document Detail

Optic nerve sheath diameter, intracranial pressure and acute mountain sickness on Mount Everest: a longitudinal cohort study.
MedLine Citation:
PMID:  18182624     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the association of optic nerve sheath diameter (ONSD), as a correlate of intracranial pressure (ICP), with acute mountain sickness (AMS). DESIGN: Longitudinal cohort study of mountaineers from sea level to 6400 m. SETTING: Mount Everest (North side). PARTICIPANTS: 13 mountaineers (10 men, 3 women; aged 23-52 years) on a British expedition to climb Mount Everest. INTERVENTIONS: ONSD was measured ultrasonically, 3 mm behind the globe using B scans recorded with an OTI-Scan 3D scanner (Ophthalmic Technologies, Canada). Serial binocular scans were recorded at sea level, and 2000, 3700, 5200 and 6400 m. All ONSDs were measured by a blinded observer. MAIN OUTCOME MEASURES: ONSD, AMS score (using the Lake Louise scoring system), heart rate, and oxygen saturation levels. RESULTS: All results were analysed by regression analysis with adjustment. ONSD was positively associated with increasing altitude above sea level (0.10 mm increase in ONSD per 1000 m, 95% CI 0.05 to 0.14 mm) and AMS score (0.12 mm per score, 95% CI 0.06 to 0.18 mm); further associations were found with resting heart rate (0.29 mm per 20 beats/min, 95% CI 0.17 to 0.41 mm) and oxygen saturations (0.20 mm per 10% decrease, 95% CI 0.11 to 0.29 mm). CONCLUSIONS: ONSD increases at high altitude, and this increase is associated with more severe symptoms of AMS. Given the linkage between ONSD and ICP, these results strongly suggest that intracranial pressure plays an important role in the pathophysiology of AMS.
A I Sutherland; D S Morris; C G Owen; A J Bron; R C Roach
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-01-08
Journal Detail:
Title:  British journal of sports medicine     Volume:  42     ISSN:  1473-0480     ISO Abbreviation:  Br J Sports Med     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-12     Completed Date:  2008-06-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0432520     Medline TA:  Br J Sports Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  183-8     Citation Subset:  IM    
Wellcome Research Training Fellow, Nuffield Department of Surgery, Level 6, John Radcliffe Hospital, Oxford OX3 9DU, UK.
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MeSH Terms
Acute Disease
Altitude Sickness / etiology*,  physiopathology
Epidemiologic Methods
Intracranial Pressure / physiology*
Middle Aged
Mountaineering / physiology*
Optic Nerve / ultrasonography*

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