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Abstract - Case Report

J Cerebrovasc Endovasc Neurosurg. 2020 22(4): 287-293
The Journal of Cerebrovascular and Endovascular Neurosurgery
      
 
Real-time change of optic nerve sheath diameter after rebleeding of ruptured intracranial dissecting aneurysm

Ultrasonographic measurement of optic nerve sheath diameter (ONSD) has been validated to detect and monitor the increased intracranial pressure (IICP) in neurosurgical field. Especially, the ONSD has been known to reflect well the ICP in case of intracranial hemorrhage (ICH) occurring in the anterior circulation of intracranial vascular system, however it has not been well elucidated the role of ONSD in the posterior circulating vascular problems. A 43-year-old man presented with a subarachnoid hemorrhage with intraventricular hemorrhage due to rupture of dissecting aneurysm at right vertebral artery, and immediately performed the stent-assisted coil embolization. Two day after coil embolization, he became nearly alert without definite neurologic deficits. The ONSD was reduced from 5.8 mm to 5.5 mm. The 10th postoperative days, the patient suddenly changed into stuporous mentality due to rebleeding of aneurysm. The ONSD was enlarged to 6.7 mm. We report a case of intimate relationship between ONSD and IICP after rupture of dissecting aneurysm located in posterior circulation.
 
Key words : Optic nerve sheath diameter, Intracranial pressure, Ultrasonography
 
 
    
 
 
 

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The Journal of Cerebrovascular and Endovascular Neurosurgery (JCEN), Department of Neurosurgery, Wonkwang University
School of Medicine and Hospital, 895, Muwang-ro, Iksan-si, Jeollabuk-do 54538, Korea.
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