Fetal optic nerve sheath measurement as a non-invasive tool for assessment of increased intracranial pressure

Fetal optic nerve sheath measurement as a non-invasive tool for assessment of increased intracranial pressure

Author Haratz, Karina Krajden Autor UNIFESP Google Scholar
Vinals, F. Google Scholar
Lev, D. Google Scholar
Feit, H. Google Scholar
Ben-Sira, L. Google Scholar
Lerman-Sagie, T. Google Scholar
Malinger, G. Google Scholar
Institution Wolfson Med Ctr
Universidade Federal de São Paulo (UNIFESP)
Ctr AGB Ultrasonog & Clin Sanatorio Aleman
Tel Aviv Med Ctr & Sch Med
Tel Aviv Univ
Abstract Objectives To describe the sonographic technique for assessment of the fetal optic nerve sheath and to report on three fetuses with intracranial lesions and enlarged optic nerve sheath diameter (ONSD) compared with normal controls matched for gestational age (GA).Methods in this cross-sectional study ONSD was measured sonographically in three fetuses (aged 23, 24 and 35 gestational weeks) with intracranial findings associated with increased intracranial pressure (ICP; dural thrombosis and intracranial tumors) as well as 42 healthy controls matched for GA +/- 1 week (aged 22-25 and 34-36 weeks). for fetal eye assessment, transabdominal and transvaginal routes and high-resolution transducers were used for optimal visualization depending on fetal position. Measurements were made using an axial view at the level of the orbits, with the fetal face positioned towards the transducer. the ONSD was measured 1.5 or 2 mm behind the papilla (depending on GA) in all fetuses. Mean +/- 2 SD ONSD of controls were calculated for each GA and compared with data from the three fetuses with intracranial pathology.Results in the 42 normal fetuses, ONSD increased from 1.2 mm at 23 weeks to 2.6 mm at 36 weeks. the measurements at 36 weeks correlated well with those observed in newborns. ONSD measurements of the three cases were above mean + 2 SD of values obtained from healthy controls at the same GA and also exceeded values of fetuses that were 1 week older.Conclusions Fetal ONSD measurement is feasible using a technique similar to that used in adults and children. ONSD enlargement was observed in all three fetuses with intracranial lesions and may be an early tool with which to diagnose increased ICP. Copyright (C) 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Keywords fetal brain
fetal neurosonography
intracranial pressure
optic nerve
prenatal diagnosis
Language English
Date 2011-12-01
Published in Ultrasound in Obstetrics & Gynecology. Malden: Wiley-Blackwell, v. 38, n. 6, p. 646-651, 2011.
ISSN 0960-7692 (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 646-651
Origin http://dx.doi.org/10.1002/uog.9050
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000298257600008
URI http://repositorio.unifesp.br/handle/11600/34237

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