title: Feasibility and usefulness of ultrasonography in idiopathic intracranial hypertension or secondary intracranial hypertension.
abstract: BACKGROUND
  Transorbital sonography (TOS) has been proven to be able to non-invasively detect elevated intracranial pressure. In this condition TOS shows an increase in optic nerve sheath diameter (ONSD). It has been suggested that internal jugular vein valve insufficiency (IJVVI) may represent a factor contributing to the pathogenesis of idiopathic intracranial hypertension (IIH). The aim of this study was to investigate whether patients with IIH or secondary IH have higher ONSD values and higher frequency of IJVVI compared to subjects without IH.
  
  
  METHODS
  Twenty-one patients with newly diagnosed IIH or secondary IH were prospectively evaluated and compared with 21 age, gender and BMI-matched controls. Experienced vascular sonographers used B-mode TOS to evaluate ONSD, optic nerve diameter (OND) and IJVVI. CSF opening pressures were also measured.
  
  
  RESULTS
  ONSD values were significantly higher in patients (6.50 ± 0.67) than controls (5.73 ± 0.66; p < 0.0001). No differences were found in OND values between patients (2.99 ± 0.26) and controls (2.93 ± 0.41; p = 0.574). No correlation was demonstrated between ONSD and CSF opening pressure (r = 0,086) (p = 0.73). No difference in frequency of IJVVI between patients (11/42 valves, 26 %) and controls (9/42, 21 %) was observed (p = 0.777).
  
  
  CONCLUSIONS
  Increased ONSD values detected by TOS support the diagnosis of IH. Our results do not support the hypothesis of a venous congestion as a potential factor contributing to the pathogenesis of IIH.
  
  
  BACKGROUND
  Not applicable. Observational, non-interventional study.
authors.affiliation: Department of Neurology, University of the Saarland, Homburg Saar, Germany.|Department of Translational Medicine, Section of Neurology, University of Piedmont East "A. Avogadro", Novara, Italy.
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Lochner
authors.affiliation: Department of Neurological, Biomedica, and Movement Sciences, University of Verona, Verona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Brio
authors.affiliation: Neurology Unit, Stroke Unit, IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Zedde
authors.affiliation: Department of Neurology, General Hospital Madonna del Soccorso, San Benedetto del Tronto, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Sanguigni
authors.affiliation: Department of Translational Medicine, Section of Neurology, University of Piedmont East "A. Avogadro", Novara, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Coppo
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Nardone
authors.affiliation: Department of Translational Medicine, Section of Neurology, University of Piedmont East "A. Avogadro", Novara, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Naldi
authors.affiliation: Department of Internal Medicine, Health Sciences, University "A. Avogadro", Novara, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Sola
authors.affiliation: Neurological Practice, and Department of Neurology, Justus-Liebig-University Giessen, Juergen-Ponto-Platz 2, D-60329, Frankfurt am Main, Germany. erwin.stolz@neuro.med.uni-giessen.de.
authors.forename: Erwin
authors.initials: E
authors.lastname: Stolz
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000000981:diagnostic imaging* / Q000209:etiology; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000000981:diagnostic imaging*; D009915:Orbit; D011559:Pseudotumor Cerebri / Q000000981:diagnostic imaging / Q000209:etiology; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
keywords: Idiopathic intracranial hypertension; Optic nerve; Sonography