E-ISSN 1309-4866
Araştırma Makalesi
Postspinal Baş Ağrısı Tanı ve Takibinde Optik Sinir Kılıf Çapının Önemi
1 Department of Anesthesiology and Reanimation, Karadeniz Technical University School of Medicine, Trabzon, Turkey  
2 Department of Algology, Balıkesır Atatürk Hospital, Balıkesir, Turkey  
Arch Neuropsychiatry ; : -
DOI: 10.5152/npa.2017.22883
0 kez okundu, 0 kez indirildi

Anahtar Kelimeler: ONSD (Optik Sinir Kılıf Çapı), İntrakraniyal hipotansiyon, post spinal baş ağrısı

Introduction: Intracranial hypotension-induced headache is caused by reduction in the volume or pressure of the cerebrospinal fluid. Headache might develop secondary to lumbar puncture. There is a good correlation between ultrasound-guided optic nerve sheath diameter (ONSD) and invasive methods. The aim of the study is to investigate the effectiveness of alteration in ultrasound-guided ONSD in diagnosis and treatment of post dural puncture headache (PDPH) induced by intracranial hypotension.


Methods: Our study involved 40 adult patients aged 18-65 scheduled to have surgery under spinal anesthesia. Patients were randomized into two groups consisting of PDPH (Group H, n=20) and control (Group C, n=20) during their post-operative period. The ONSDs of patients were measured via ultrasound, pain severity with Numeric Rating Scale (NRS) pre-operatively, at 24th, 26th and 48th hours post-operatively. Conservative treatment was started on the 24th hour in PDPH group.


Results: There was no significant difference between the groups in terms of demographic data. In Group H, the reduction in ONSD from 3.8±0.2 to 3.2±0.3mm in postoperative 24th hours (p=0.001) and an increase to 4.4±0.3mm in postoperative 48th hours (p=0.03) were significant. When compared to postoperative 24th hours, ONSD in postoperative 26th (3.9±0.3mm) and 48th hours (4.4±0.3mm) were significantly higher (p=0.007 and p=0.01; respectively) in Group H. NRS values in Group H at postoperative 26th and 48th hours were significantly lower compared to postoperative 24th hours (p=0.001).



Conclusions: We believe that serial measurement of ultrasound-guided ONSD, which is considered a simple and non-invasive procedure in the determination of intracranial pressure changes, is a more objective method in the follow-up of intracranial hypotension-induced headache compared to NRS evaluation.

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Son Güncelleme: 29.12.2017