Abstract：
Spontaneous cerebrospinal fluid (sCSF) leaks develop from pressure erosion due to idiopathic intracranial hypertension, treatment of which is paramount to preventing recurrence. Direct measurements of intracranial pressure (ICP) for monitoring response to treatment via lumbar drain (LD) or ventriculostomy are invasive and have risks. The objectives of this study are to determine whether ultrasonographic measurements of optic nerve sheath diameter (ONSD) correlate with LD ICP in patients with sCSF leaks undergoing treatment, and whether ONSDs are larger in patients with sCSF leaks than controls.
Subjects with sCSF leaks and controls were prospectively recruited. ONSD, sex, and body mass index (BMI) were analyzed. For sCSF leak subjects, ultrasonography was performed at the time of LD opening and each pressure check postoperatively, including the acetazolamide response. In control patients, measurements were obtained at the time of surgery. Pearson\'s correlation between ONSD and ICP was performed.
Subjects with sCSF leaks (n = 9, age 52.4 ± 9.5, all female) and controls (n = 8, age 60.1 ± 14.8, two females) had significantly different BMIs, 38.4 ± 8.1 vs. 29.2 ± 4.8, t(15) = 2.793, p = 0.014. ONSD was strongly correlated with ICP measurements (r = 0.583, p = 0.002). However, percentage change in ONSD and ICP measurements were more strongly correlated (r = 0.733, p < 0.001). Patients with sCSF leaks had significantly higher ONSDs than controls, 0.63 cm ± 0.044 vs. 0.56 cm ± 0.074, t(15) = 2.329, p = 0.034.
ONSD significantly correlated with ICP in sCSF leak patients and was wider in sCSF leak subjects than controls. Ultrasonography has utility in monitoring the ICP response to acetazolamide.
Subjects with sCSF leaks and controls were prospectively recruited. ONSD, sex, and body mass index (BMI) were analyzed. For sCSF leak subjects, ultrasonography was performed at the time of LD opening and each pressure check postoperatively, including the acetazolamide response. In control patients, measurements were obtained at the time of surgery. Pearson\'s correlation between ONSD and ICP was performed.
Subjects with sCSF leaks (n = 9, age 52.4 ± 9.5, all female) and controls (n = 8, age 60.1 ± 14.8, two females) had significantly different BMIs, 38.4 ± 8.1 vs. 29.2 ± 4.8, t(15) = 2.793, p = 0.014. ONSD was strongly correlated with ICP measurements (r = 0.583, p = 0.002). However, percentage change in ONSD and ICP measurements were more strongly correlated (r = 0.733, p < 0.001). Patients with sCSF leaks had significantly higher ONSDs than controls, 0.63 cm ± 0.044 vs. 0.56 cm ± 0.074, t(15) = 2.329, p = 0.034.
ONSD significantly correlated with ICP in sCSF leak patients and was wider in sCSF leak subjects than controls. Ultrasonography has utility in monitoring the ICP response to acetazolamide.
摘要：
背景：自发性脑脊液（sCSF）泄漏是由特发性颅内高压（IIH）引起的压力侵蚀引起的。IIH的治疗对于预防复发至关重要。直接测量ICP以监测通过腰椎引流或脑室造口术对治疗的反应是侵入性的，并且存在风险。这项研究的目的是确定视神经鞘直径（ONSD）的超声测量是否与接受治疗的sCSF泄漏患者的LDICP相关，以及sCSF泄漏患者的ONSD是否大于对照组。
方法：前瞻性招募患有sCSF泄漏和对照的受试者。ONSD，性别,分析体重指数(BMI)。对于sCSF泄漏受试者，超声检查在LD打开压力时进行，每次检查术后，包括乙酰唑胺反应。在控制患者中，测量是在手术时获得的。进行了ONSD和ICP之间的Pearson相关性。
结果：患有sCSF泄漏的受试者（n=9，年龄52.4±9.5，均为女性）和对照组（n=8，年龄60.1±14.8，2名女性）的BMI显着不同（38.4±8.1，vs.29.2±4.8,t(15)=2.793,p=0.014)。ONSD与LP测量值密切相关（r=0.583，p=0.002）。然而,ONSD和LP测量值的变化百分比相关性更强(r=0.733,p<0.001).sCSF泄漏患者的ONSD明显高于对照组（0.63cm±0.044，vs.0.56cm±0.074,t(15=2.329,p=0.034)。
结论：在sCSF渗漏患者中，ONSD与ICP显著相关，在sCSF渗漏患者中，ONSD比对照组更广泛。超声检查可用于监测ICP对乙酰唑胺的反应。本文受版权保护。保留所有权利。
方法：前瞻性招募患有sCSF泄漏和对照的受试者。ONSD，性别,分析体重指数(BMI)。对于sCSF泄漏受试者，超声检查在LD打开压力时进行，每次检查术后，包括乙酰唑胺反应。在控制患者中，测量是在手术时获得的。进行了ONSD和ICP之间的Pearson相关性。
结果：患有sCSF泄漏的受试者（n=9，年龄52.4±9.5，均为女性）和对照组（n=8，年龄60.1±14.8，2名女性）的BMI显着不同（38.4±8.1，vs.29.2±4.8,t(15)=2.793,p=0.014)。ONSD与LP测量值密切相关（r=0.583，p=0.002）。然而,ONSD和LP测量值的变化百分比相关性更强(r=0.733,p<0.001).sCSF泄漏患者的ONSD明显高于对照组（0.63cm±0.044，vs.0.56cm±0.074,t(15=2.329,p=0.034)。
结论：在sCSF渗漏患者中，ONSD与ICP显著相关，在sCSF渗漏患者中，ONSD比对照组更广泛。超声检查可用于监测ICP对乙酰唑胺的反应。本文受版权保护。保留所有权利。
