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Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition
06:09

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Published on: August 18, 2023

Optic nerve sheath diameter and acute mountain sickness.

Linda E Keyes1, Ryan Paterson, Dowin Boatright

  • 1Department of Emergency Medicine, University of Colorado, Denver, CO, USA. Linda.Keyes@aya.yale.edu

Wilderness & Environmental Medicine
|February 22, 2013
PubMed
Summary

Optic nerve sheath diameter (ONSD) increased in subjects with acute mountain sickness (AMS) at high altitude, but the changes were small and not clinically significant. This study suggests increased intracranial pressure (ICP) is unlikely to cause mild to moderate AMS.

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Area of Science:

  • High-altitude physiology
  • Neurology
  • Medical imaging

Background:

  • Acute mountain sickness (AMS) is a common condition at high altitudes.
  • Increased intracranial pressure (ICP) is a potential contributor to AMS.
  • Optic nerve sheath diameter (ONSD) measured by ultrasound (US) is a noninvasive marker for elevated ICP.

Purpose of the Study:

  • To investigate if ONSD increases with rapid ascent to high altitude (4300 m).
  • To determine if increased ONSD correlates with AMS symptoms.
  • To assess the effect of oxygen treatment on ONSD and AMS symptoms.

Main Methods:

  • A cohort study involving 57 healthy subjects.
  • Ultrasound measurement of ONSD at 1400 m and 4300 m.
  • Comparison between subjects with and without AMS (Lake Louise Score ≥3), before and after oxygen treatment.

Main Results:

  • 51% of subjects developed AMS at 4300 m.
  • Mean ONSD increased in subjects with AMS at 4300 m, but not in those without AMS.
  • Oxygen treatment reduced mean ONSD in AMS subjects; however, individual variations were significant and differences were small.

Conclusions:

  • Mean ONSD increased in subjects with AMS at high altitude, but individual variations were high.
  • Observed ONSD changes were small, potentially within the margin of error for ultrasound.
  • The study does not support a significant role for increased ICP in mild to moderate AMS.