title: Sonographic assessment of the optic nerve sheath and transorbital monitoring of treatment effects in a patient with spontaneous intracranial hypotension: case report.
abstract: OBJECTIVE
  To investigate the potential of the ultrasound-based evaluation of the optic nerve sheath in a patient with spontaneous intracranial hypotension due to cervical cerebrospinal fluid (CSF) leakage.
  
  
  METHODS
  Repeated measurements of the optic nerve sheath diameter (ONSD) using B-mode sonography were performed before treatment initiation, during medical treatment, and during a course of repeated placement of epidural blood patches.
  
  
  RESULTS
  On admission, transorbital sonography revealed a decreased ONSD of 4.1 mm on the right and 4.3 mm on the left side. After 8 months of treatment with caffeine and computed tomography-guided epidural blood patches a gradual distension of the ONSD into the normal range was bilaterally observed (right: 5.2 mm; left: 5.3 mm).
  
  
  CONCLUSIONS
  The ultrasound-based evaluation of the optic nerve sheath may be helpful in detecting CSF hypovolemia and for determination of treatment effects. This report should be seen as a basis for future investigations on the sonographic assessment of the optic nerve sheath in diagnosis and treatment of intracranial hypotension.
authors: Department of Neurology, Justus-Liebig-University, Giessen, Germany. jochenbaeuerle@gmx.de
authors: Jochen
authors: J
authors: Bäuerle
authors: Elke R
authors: ER
authors: Gizewski
authors: Kerstin von
authors: Kv
authors: Stockhausen
authors: Bernhard
authors: B
authors: Rosengarten
authors: Martin
authors: M
authors: Berghoff
authors: Astrid E
authors: AE
authors: Grams
authors: Manfred
authors: M
authors: Kaps
authors: Max
authors: M
authors: Nedelmann
mesh_terms: D017217:Blood Patch, Epidural; D004453:Echoencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D019585:Intracranial Hypotension / Q000000981:diagnostic imaging* / Q000209:etiology*; D008875:Middle Aged; D009900:Optic Nerve / Q000000981:diagnostic imaging*; D009915:Orbit / Q000000981:diagnostic imaging; D013353:Subdural Effusion / Q000150:complications* / Q000000981:diagnostic imaging*; D016896:Treatment Outcome