title: Ocular color-coded sonography - a promising tool for neurologists and intensive care physicians.
abstract: Ocular color-coded duplex sonography (OCCS), when performed within the safety limits of diagnostic ultrasonography, is an easy noninvasive technique with high potential for diagnosis and therapy in diseases with raised intracranial pressure and vascular diseases affecting the eye. Despite the capabilities of modern ultrasound systems and its scientific validation, OCCS has not gained widespread use in neurological practice. In this review, the authors describe the technique and main parameter settings of OCCS systems to reduce potential risks as thermal or cavitational effects for sensitive orbital structures. Applications of OCCS are the determination of intracranial pressure in emergency medicine, and follow-up evaluations of idiopathic intracranial hypertension and ventricular shunting by measuring the optic nerve sheath diameter. A diameter of 5.7 - 6.0 mm corresponds well with symptomatically increased intracranial pressure (> 20 cmH2O). OCCS also helps to discriminate between different etiologies of central retinal artery occlusion - by visualization of a "spot sign" and Doppler flow analysis of the central retinal artery - and aids the differential diagnosis of papilledema. At the end perspectives are illustrated that combine established ultrasound methods such as transcranial color-coded sonography with OCCS.
authors.affiliation: Department of Neurology, Bezirksklinikum Regensburg, University of Regensburg.
authors.forename: M
authors.initials: M
authors.lastname: Ertl
authors.affiliation: Department of Neurology, Bezirksklinikum Regensburg, University of Regensburg.
authors.forename: F
authors.initials: F
authors.lastname: Barinka
authors.affiliation: Department of Neurology, Bezirksklinikum Regensburg, University of Regensburg.
authors.forename: E
authors.initials: E
authors.lastname: Torka
authors.affiliation: Department of Opthalmology, University of Regensburg.
authors.forename: M
authors.initials: M
authors.lastname: Altmann
authors.affiliation: Department of Surgery, Vascular Surgery and Endovascular Surgery, University of Regensburg.
authors.forename: K
authors.initials: K
authors.lastname: Pfister
authors.affiliation: Department of Opthalmology, University of Regensburg.
authors.forename: H
authors.initials: H
authors.lastname: Helbig
authors.affiliation: Department of Neurology, Bezirksklinikum Regensburg, University of Regensburg.
authors.forename: U
authors.initials: U
authors.lastname: Bogdahn
authors.affiliation: Department of Opthalmology, University of Regensburg.
authors.forename: M A
authors.initials: MA
authors.lastname: Gamulescu
authors.affiliation: Department of Neurology, Bezirksklinikum Regensburg, University of Regensburg.
authors.forename: F
authors.initials: F
authors.lastname: Schlachetzki
mesh_terms: D003422:Critical Care; D004632:Emergency Medical Services; D005123:Eye / Q000098:blood supply* / Q000000981:diagnostic imaging*; D006801:Humans; D011559:Pseudotumor Cerebri / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D017585:Ultrasonography, Doppler, Transcranial; D014652:Vascular Diseases / Q000000981:diagnostic imaging*