J Cerebrovasc Endovasc Neurosurg > Volume 22(4); 2020 > Article
Journal of Cerebrovascular and Endovascular Neurosurgery 2020;22(4):287-293.
DOI: https://doi.org/10.7461/jcen.2020.E2020.11.003    Published online December 31, 2020.
Real-time change of optic nerve sheath diameter after rebleeding of ruptured intracranial dissecting aneurysm
Hae-Won Koo 
Department of Neurosurgery, Inje University, Ilsan Paik Hospital, Neuroscience, Radiosurgery and Adaptive Hybrid Neurosurgery Research Center, Goyang, Korea
Correspondence:  Hae-Won Koo, Tel: +82-31-910-7740, Fax: +82-31-915-0885, 
Email: hwkoo@paik.ac.kr
Received: 12 November 2020   • Revised: 7 December 2020   • Accepted: 17 December 2020
Abstract
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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