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Child's Nervous System

, Volume 29, Issue 2, pp 269–274 | Cite as

Does optic nerve sheath diameter on MRI decrease with clinically improved pediatric hydrocephalus?

  • Ash SinghalEmail author
  • Michael M. H. Yang
  • Michael A. Sargent
  • D. Douglas Cochrane
Original Paper

Abstract

Introduction

Serial change in ventricular size is recognized as an imperfect indicator of ongoing hydrocephalus in children. Potentially, other radiographic features may be useful in determining the success of hydrocephalus interventions. In this study, optic nerve sheath diameter (ONSD), optic nerve tortuosity, and optic disk bulging were assessed as indicators of hydrocephalus control in children who underwent endoscopic third ventriculostomy (ETV) or posterior fossa tumor resection.

Methods

Sixteen children underwent ETV or tumor resection for treatment of hydrocephalus. T2-weighted axial magnetic resonance images of the orbit were obtained, and the ONSD was measured posterior to the optic globe, pre- and post-intervention. Evidence of optic disk bulging and optic nerve tortuosity was also assessed. Ventricular size was estimated using the frontal and occipital horn ratio (FOR).

Results

There was a significant reduction in the ONSD post-ETV (n = 9) and after tumor resection (n = 7). Average preoperative ONSD was 6.21 versus 5.71 mm postoperatively (p = 0.0017).There was also an 88 % (p = 0.011) and 60 % (p = 0.23) reduction in optic disk bulging and tortuosity, respectively. The FOR normalized in the tumor resection group but not the ETV group. After intervention, all patients showed improvement in signs and symptoms of hydrocephalus.

Conclusion

In our study population, ONSD decreased in response to measures to reduce hydrocephalus. Optic disk bulging also appears to resolve. Serial reduction in ONSD, and optic disk bulging may be indicators of improved hydrocephalus following pediatric neurosurgical interventions.

Keywords

Optic nerve sheath diameter Hydrocephalus Pediatrics Ventricular size 

Notes

Acknowledgments

The authors gratefully acknowledge the work of Michael Kerr, who assisted in manuscript preparation and editing.

Conflict of interest

The authors would like to declare that no conflict of interest exists.

Ethics

Ethical approval for this study was provided by the University of British Columbia and Children's and Women's Health Centre Research Ethics Board, approval number: H11-02644. All research activities were performed in accordance with the ethical standards of good clinical practice as outlined in the 1964 Declaration of Helsinki.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Ash Singhal
    • 1
    Email author
  • Michael M. H. Yang
    • 1
  • Michael A. Sargent
    • 2
  • D. Douglas Cochrane
    • 1
  1. 1.Department of Surgery, Division of Pediatric NeurosurgeryUniversity of British Columbia and BC Children’s HospitalVancouverCanada
  2. 2.Department of RadiologyUniversity of British Columbia and BC Children’s HospitalVancouverCanada

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