| Sonography for determining the optic nerve sheath diameter with increasing intracranial pressure in a porcine model. | |
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MedLine Citation:
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PMID: 21527613 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study investigated whether it is feasible to use sonography to monitor changes in the optic nerve sheath diameter in a porcine model. METHODS: A fiber-optic intracranial pressure transducer was surgically placed through the frontal sinus directly into the brain parenchyma of adult Yorkshire pigs (n = 5). A second bolt was placed on the contralateral side for intraparenchymal fluid infusion. Optic nerve sheath diameter measurements were acquired by each of 2 ultrasound operators around the leading edge of the nerve, 3 to 5 mm distal from the origin of the optic nerve. To induce a change in diameter, intracranial pressure was manipulated by injecting normal saline into the intraparenchymal infusion catheter located in the symmetric contralateral position as the pressure-monitoring probe. RESULTS: Data from 1 pig were unusable because of a cerebrospinal fluid leak into the sinus and orbital fissure. Saline aliquots of 1 to 10 mL were able to generate intracranial pressures typically starting from 10 to 15 mm Hg and increasing to 75 to 90 mm Hg, which eventually evoked a Cushing response. Fluid injection was controlled to increase pressures by 60 mm Hg over a 15- to 20-minute period. Regression analysis of all animals showed that the optic nerve sheath diameter increased by 0.0034 mm/mm Hg of intracranial pressure; however, this slope ranged from 0.0025 to 0.0046, depending on the animal measured. There was no discernible effect of the ultrasound operator on the slope; however, measurements made by 1 operator were consistently higher than the others by about 8% of the overall diameter range. CONCLUSIONS: These results suggest that the use of the optic nerve sheath diameter to noninvasively confirm acute changes in intracranial pressure over 1 hour is feasible in a porcine model. We recommend that this method be validated in humans using direct intracranial pressure measurement where possible to confirm it as a screening tool for acute and chronically increased diameters secondary to elevated pressure in clinical settings. |
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Authors:
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Douglas R Hamilton; Ashot E Sargsyan; Shannon L Melton; Kathleen M Garcia; Bill Oddo; David S Kwon; Alan H Feiveson; Scott A Dulchavsky |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine Volume: 30 ISSN: 1550-9613 ISO Abbreviation: J Ultrasound Med Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-29 Completed Date: 2011-09-26 Revised Date: 2012-02-07 |
Medline Journal Info:
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Nlm Unique ID: 8211547 Medline TA: J Ultrasound Med Country: United States |
Other Details:
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Languages: eng Pagination: 651-9 Citation Subset: IM |
Affiliation:
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Wyle Laboratories/ National Aeronautics and Space Administration, Houston, TX 77058, USA. douglas.r.hamilton@nasa.gov |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Disease Models, Animal* Female Humans Image Enhancement / methods Image Interpretation, Computer-Assisted / methods* Intracranial Hypertension / physiopathology, ultrasonography* Intracranial Pressure* Optic Nerve / ultrasonography* Reproducibility of Results Sensitivity and Specificity Swine Ultrasonography / methods |
| Comments/Corrections | |
Comment In:
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J Ultrasound Med. 2012 Jan;31(1):130-1
[PMID:
22215781
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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