Ultrasound-guided initial diagnosis and follow-up of pediatric idiopathic intracranial hypertension

• Published in: Pediatric radiology 2024-05, Vol.54 (6), p.1001-1011
• Main Authors: Kerscher, Susanne Regina, Zipfel, Julian, Haas-Lude, Karin, Bevot, Andrea, Schuhmann, Martin Ulrich
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Child, Preschool; Diagnosis; Diameters; Female; Follow-Up Studies; Humans; Hydrocephalus; Hypertension; Imaging; Infant; Intracranial pressure; Male; Medicine; Medicine & Public Health; Nerves; Neuroradiology; Nuclear Medicine; Oncology; Optic nerve; Optic Nerve - diagnostic imaging; Original; Original Article; Pediatrics; Pressure measurement; Prospective Studies; Pseudotumor Cerebri - diagnostic imaging; Radiology; Reproducibility of Results; Sensitivity and Specificity; Sheaths; Third Ventricle - diagnostic imaging; Transducers; Ultrasonic imaging; Ultrasonography, Interventional - methods; Ultrasound; Ventricle; Ventricles (cerebral)
• ISSN: 1432-1998; 0301-0449; 1432-1998
• DOI: 10.1007/s00247-024-05905-9

Background Idiopathic intracranial hypertension in children often presents with non-specific symptoms found in conditions such as hydrocephalus. For definite diagnosis, invasive intracranial pressure measurement is usually required. Ultrasound (US) of the optic nerve sheath diameter provides a non-invasive method to assess intracranial pressure. Transtemporal US allows imaging of the third ventricle and thus assessment for hydrocephalus. Objective To investigate whether the combination of US optic nerve sheath and third ventricle diameter can be used as a screening tool in pediatric idiopathic intracranial hypertension to indicate elevated intracranial pressure and exclude hydrocephalus as an underlying pathology. Further, to analyze whether both parameters can be used to monitor treatment outcome. Materials and methods We prospectively included 36 children with idiopathic intracranial hypertension and 32 controls. Using a 12-Mhz linear transducer and a 1–4-Mhz phased-array transducer, respectively, optic nerve sheath and third ventricle diameters were determined initially and during the course of treatment. Results In patients, the mean optic nerve sheath diameter was significantly larger (6.45±0.65 mm, controls: 4.96±0.32 mm) and the mean third ventricle diameter (1.69±0.65 mm, controls: 2.99±1.31 mm) was significantly smaller compared to the control group, P