Real time optic nerve sheath diameter measurement during lumbar puncture

Area of Science:

• Neurology
• Medical Imaging
• Ultrasound Technology

Background:

• Optic nerve sheath diameter (ONSD) ultrasound is a non-invasive method to estimate intracranial pressure (ICP).
• Previous studies have correlated ONSD measurements with direct ICP monitoring and after interventions like lumbar puncture (LP) and ventricular shunts.
• Idiopathic intracranial hypertension (IIH) is a condition characterized by elevated ICP without a clear secondary cause.

Observation:

• This case report details serial ONSD measurements using point of care ultrasound.
• Dynamic changes in ONSD were observed during a lumbar puncture procedure in a patient diagnosed with IIH.
• The study highlights the feasibility of real-time ONSD monitoring during interventions.

Findings:

• Point of care ultrasound accurately measured ONSD, reflecting ICP dynamics.
• Significant ONSD variations were noted correlating with cerebrospinal fluid (CSF) drainage during LP.
• The findings support ONSD ultrasound as a responsive indicator of ICP fluctuations.

Implications:

• Real-time ONSD ultrasound can provide valuable insights into ICP management during procedures like LP.
• This technique may enhance the monitoring of patients with conditions causing raised ICP, such as IIH.
• Point of care ultrasound offers a practical, non-invasive tool for dynamic ICP assessment in clinical settings.