PDF(Pubmed)
Abstract：
Introduction Optic nerve sheath diameter (ONSD) measured using ultrasonography has been widely used as a surrogate marker of elevated intracranial pressure. However, literature is sparse on the correlation between ONSD and ventriculoperitoneal (VP) shunt function, especially in adults with hydrocephalus. Our study was designed to assess the correlation between ONSD measured using ultrasonography before and 12 hours after VP shunt placement and the success of VP shunt placement assessed using computed tomography (CT) of the brain. Materials and Methods Fifty-one patients between 16 and 60 years of age, with obstructive hydrocephalus scheduled for VP shunt surgery were included in this prospective, observational study. ONSD measurements were obtained from both eyes prior to induction of anesthesia, immediately after the surgery, and at 6, 12, and 24 hours after the surgery. An average of three readings was obtained from each eye. Cerebrospinal fluid (CSF) opening pressure was noted after entry into the lateral ventricle. Noncontrast CT (NCCT) brain was obtained 12 hours after the surgery and was interpreted by the same neurosurgeon for signs of successful VP shunt placement. Results There was a significant reduction in ONSD in the postoperative period compared to ONSD measured preoperatively. The average ONSD (mean ± standard deviation) measured prior to induction of anesthesia, immediately after the surgery, and at 6, 12, and 24 hours after the surgery was 5.71 ± 0.95, 5.20 ± 0.84, 5.06 ± 0.79, 4.90 ± 0.79, and 4.76 ± 0.75 mm, respectively. The mean CSF opening pressure was 19.6 ± 6.9 mm Hg. Postoperative NCCT brain revealed misplacement of the shunt tip in only one patient. Conclusion ONSD measured using ultrasonography may be used as a reliable indicator of VP shunt function in adults with obstructive hydrocephalus.
摘要：
介绍使用超声检查测量的视神经鞘直径（ONSD）已被广泛用作颅内压升高的替代标记。然而,关于ONSD和脑室腹膜（VP）分流功能之间的相关性的文献很少，尤其是成人脑积水。我们的研究旨在评估VP分流器放置之前和之后12小时使用超声测量的ONSD与使用大脑计算机断层扫描（CT）评估的VP分流器放置成功之间的相关性。材料和方法51例年龄在16至60岁之间的患者，计划进行VP分流手术的梗阻性脑积水被纳入本前瞻性研究，观察性研究。麻醉诱导前从双眼获得ONSD测量值，手术后立即，在手术后6、12和24小时。从每只眼睛获得三个读数的平均值。进入侧脑室后注意到脑脊液（CSF）开放压力。手术后12小时获得非对比CT（NCCT）脑，并由同一位神经外科医生解释为成功放置VP分流的迹象。结果与术前测量的ONSD相比，术后ONSD显着降低。麻醉诱导前测量的平均ONSD（平均值±标准偏差），手术后立即，术后6、12和24小时分别为5.71±0.95、5.20±0.84、5.06±0.79、4.90±0.79和4.76±0.75mm，分别。平均CSF开放压力为19.6±6.9mmHg。术后NCCT大脑仅显示一名患者的分流尖端错位。结论超声测量的ONSD可作为成人梗阻性脑积水VP分流功能的可靠指标。
