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Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition
Published on: August 18, 2023
Increase in optic nerve sheath diameter induced by epidural blood patch: a preliminary report
C Dubost1, A Le Gouez, P J Zetlaoui
1AP-HP and University Paris-Sud, University Hospital Antoine Béclère, Department of Anaesthesiology and Critical Care, Clamart, France.
British Journal of Anaesthesia
|June 23, 2011
Summary
Post-dural puncture headache (PDPH) treatment with epidural blood patch (EBP) was associated with increased optic nerve sheath diameter (ONSD). This suggests successful EBP may normalize intracranial pressure, as indicated by ONSD changes.
Area of Science:
- Neurology
- Anesthesiology
- Ophthalmology
Background:
- Post-dural puncture headache (PDPH) is often linked to cerebrospinal fluid hypotension.
- Optic nerve sheath diameter (ONSD) measured via ocular sonography correlates with intracranial pressure (ICP) in brain-injured patients.
Purpose of the Study:
- To evaluate changes in ONSD following lumbar epidural blood patch (EBP) in patients with PDPH.
Main Methods:
- Consecutive patients undergoing EBP for PDPH were enrolled.
- ONSD and pain were measured before EBP (T(0)) and at 10 minutes (M(10)), 2 hours (H(2)), and 20 hours (H(20)) post-procedure.
Main Results:
- Ten subjects were included; ONSD increased significantly over time after EBP (P<0.02).
- Successful EBP (9/10 subjects) correlated with a sustained ONSD increase at M(10) and H(2) compared to T(0).
- The single subject with EBP failure showed only a minor ONSD increase.
Conclusions:
- Successful EBP in PDPH patients is associated with ONSD enlargement.
- This suggests that a successful EBP leads to a sustained increase in intracranial pressure, as indicated by ONSD.
- ONSD serves as a valuable, non-invasive surrogate marker for ICP changes after EBP.
