Diagnostique non invasif de l’hypertension intracrânienne via l’échographie  transorbitaire

Hadbi, Mohamed; Hamchaoui, Farida; Houari, Loucif; Abdelhalim, Morsli; Nadia, Fellah

JOURNAL DE NEUROCHIRURGIE
Volume 15, Numéro 2, Pages 41-45
2020-09-19

Diagnostique Non Invasif De L’hypertension Intracrânienne Via L’échographie Transorbitaire

Auteurs : Hadbi Mohamed . Hamchaoui Farida . Houari Loucif . Abdelhalim Morsli . Nadia Fellah .

Résumé

Introduction The gold standard in the measurement of intracranial pressure (ICP) is based on invasive devices, nevertheless the use of such a device is not easyin emergency situations, or in an inadequate environment, recently new measurement technics of intracranial hypertension (ICH) risk by ultrasound measurement of the optic nerve sheath diameter (ONSD).The objective of this study is to determine the ONSD in patients with clinico-radiological features of ICH. Materials and methods Observational prospective study conducted in the neurosurgery department of Bab El Oued, in 15 adult patients with clinico-radiological features of ICH. In the supine position, a high frequency linear ultrasound probe (7.5 MHZ) is placed on a thin layer of gel at the level of the upper eyelid; the ONSD measured 3mm behind the eyeball; two measurements are made for each of the two eyes (sagittal plane and transverse planes), the final measurement corresponds to the average of each of these measurements, performed in 3 circumstances: - before the surgery - 15 minutes after the inductionstep – first dayafter the surgery. Results and discussion The mean age was 50.47 ± 13.32 years, the sex ratio F / H was 0.87; the mean ONSD measurement was 6.94 ± 0.71 preoperatively, 6.52 ± 0.69 after induction, and 4.5 ± 0.66 postoperatively. It is noted that the ONSD was very high in patients with signs of IHC, this diameter decreases after induction, so that it becomes normal postoperatively after elimination of the cause of the IHC. Conclusion: The ONSD ultrasound measurement, coupled with a clinico-radiological context is a very useful tool in emergency situations, or in a non-specialized environment, to urgently take care of patients and avoid the unacceptable risk of ischemia or neurological sequelae.