Arrest Hidrosefalide Artmış İntrakraniyel Basıncın Optik Sinir Ultrasonografisi ile Doğrulanması

Abstract

Giriş: Arrest hidrosefali, beyin-omurilik sıvı basıncının normale döndüğü ve serebral ventriküller ile beyin parenkimi arasında basınç gradiyentinin olmadığı, hafif ventrikül genişlemesinin eşlik ettiği bir kronik hidrosefali durumudur. Olgu Sunumu: Bu olgu sunumunda, acil servise başağrısı, fotofobi ve tekrarlayan kusma ile başvuran 37 yaşında bir kadın hastayı sunmaktayız. Hasta beş yıl önce arrest hidrosefali tanısı almış ve o zamandan beri radyolojik olarak takip edilmekteydi. Hidrosefalinin akut alevlenmesini değerlendirmek ve tanı koymak için göz ultrasonografisi başarılı bir şekilde kullanıldı. Sonuç: Arrest hidrosefali farzedilen hastalar hayatlarının herhangi bir döneminde hidrosefali atağı geçirebilirler. Ultrasonografi, hidrosefalinin izlenmesinde güvenilir bir araç olarak görev alabilir, özellikle de, optik sinir kılıf çapının sonografik olarak görülmesi, bu vakalarda intrakraniyel basınç artışının doğrulanmasına yardımcı olabilir.

Keywords

• Hidrosefali, optik sinir kılıfı, ultrasonografi

Confirmation of Elevated Intracranial Pressure in Arrested Hydrocephalus by Optic Nerve Ultrasonography

Abstract

Introduction: Arrested hydrocephalus is a state of chronic hydrocephalus with mild dilatation of the ventricles in which the cerebrospinal fluid pressure has returned to normal, and there is no pressure gradient between the cerebral ventricles and brain parenchyma.Case Report: In this case report, we present a 37-year-old female patient who was admitted to emergency department with complaints of headache, photophobia, and recurrent vomiting. She had been diagnosed with arrested hydrocephalus 5 years ago and was being followed radiologically since. Ocular ultrasonography was successfully utilized to assess and diagnose acute exacerbation of hydrocephalus.Conclusion: Patients who are presumably assumed to have arrested hydrocephalus may experience an episode of hydrocephalus in any period of life. Ultrasonography can serve as a reliable tool in monitoring hydrocephalus; more specifically, sonographic visualization of the optic nerve sheath diameter may help to confirm increased intracranial pressure in such cases

Keywords

• Hydrocephalus, optic nerve sheath, ultrasonography

References

1. McLone DG, Aronyk KE. An approach to the management of arrested and compensated hydrocephalus. Pediatr Neurosurg 1993; 19: 101-3. [CrossRef]
2. Köksal V, Öktem S. Ventriculosubgaleal shunt procedure and its long-term outcomes in premature infants with post-hemorrhagic hydrocephalus. Childs Nerv Syst 2010; 26: 1505-15. [CrossRef]
3. Whittle IR, Johnston IH, Besser M. Intracranial pressure changes in arrested hydrocephalus. J Neurosurg 1985; 62: 77-82. [CrossRef]
4. Krauss JK, Halve B. Normal pressure hydrocephalus: survey on contemporary diagnostic algorithms and therapeutic decision-making in clinical practice. Acta Neurochir (Wien) 2004; 146: 379-88. [CrossRef]
5. Zhong J, Dujovny M, Park HK, Perez E, Perlin AR, Diaz FG. Advances in ICP monitoring techniques. Neurol Res 2003; 25: 339-50. [CrossRef]
6. Newman WD, Hollman AS, Dutton GN, Carachi R. Measurement of optic nerve sheath diameter by ultrasound: a means of detecting acute raised intracranial pressure in hydrocephalus. Br J Ophthalmol 2002; 86: 1109-13. [CrossRef]
7. Tayal VS, Neulander M, Norton HJ, Foster T, Saunders T, Blaivas M. Emergency department sonographic measurement of optic nevre sheath diameter to detect findings of increased intracranial pressure in adult head injury patients. Ann Emerg Med 2007; 49: 508-14. [CrossRef]
8. Amini A, Kariman H, Arhami Dolatabadi A, Hatamabadi HR, Derakhshanfar H, Mansouri B, et al. Use of the sonographic diameter of optic nerve sheath to estimate intracranial pressure. Am J Emerg Med 2013; 31: 236-9. [CrossRef]

9. Donohoe CD. The role of the physical examination in the evaluation of headache. Med Clin North Am 2013; 97: 197-216. [CrossRef]
10. Burgos Sánchez AJ, Alemán López O, Polo Tomás I, Ubeda Muñoz M, Papí Zamora M, Gras Albert JR. Otitic hydrocephalus. A report of two cases. Acta Otorrinolaringol Esp 1999; 50: 553-7.