{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:56:34Z","timestamp":1781636194822,"version":"3.54.5"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The aim of our study is to test the hypothesis whether ultrasonographically measured ultrasound-guided optic nerve sheath diameter (US-ONSD) decreases after lumbar puncture (LP) and whether decreased optic nerve sheath diameter (ONSD) after lumbar puncture is associated with headache. The latter might help to identify patients with postdural puncture headache (PDPH). In this prospective observational study 76 patients, who had undergone diagnostic LP using an atraumatic technique, received a measurement of ONSD before (T0), immediately after (T1) and 24\u00a0h after LP (T2). Additionally demographic data such as age, sex, body mass index (BMI), and also headaches and symptoms were recorded. In six out of 7 patients with constant PDPH, we additionally measured ONSD 48\u00a0h (T3) and 72\u00a0h (T4) after LP. All patients (n\u2009=\u200976, 100%) showed a physiological reduction in ONSD at T1. Patients with consistent symptoms of PDPH (n\u2009=\u20097, 9%) kept values below pre-LP levels after 24 and 48\u00a0h. No statistical difference was found in BMI, sex, cerebrospinal fluid volume, needle size, or previous headaches between the PDPH (n\u2009=\u20097, 9%) and non-PDPH patients (n\u2009=\u200969, 91%). Younger patients were more likely to experience PDPH symptoms. Since at T2 the ONSD was only reduced in PDPH patients, a significant difference in ONSD was found between PDPH and non-PDPH patients. The cut-off value of ONSD for predicting PDPH at T2 was 4.9\u00a0mm in the receiver operating characteristic (ROC) curve (sensitivity 86%, specificity 93%). We were able to demonstrate a physiologic change in ONSD after LP in all patients. The sonographic measurement of ONSD in patients with headache can help to identify and monitor PDPH after LP.<\/jats:p>","DOI":"10.1038\/s41598-026-40311-1","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T22:19:03Z","timestamp":1771625943000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound measurement of optic nerve sheath diameter pre and post lumbar puncture for prediction of postdural puncture headache"],"prefix":"10.1038","volume":"16","author":[{"given":"Fatma","family":"Merzou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Lena","family":"Kunzmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Janitschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Valdueza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Landau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Roemer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwin","family":"Stolz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurin","family":"Schappe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviana","family":"Versace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Kottackal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiorgio","family":"Lochner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"40311_CR1","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1136\/pn-2023-003986","volume":"24","author":"S Cheema","year":"2024","unstructured":"Cheema, S. et al. Spontaneous intracranial hypotension. Pract. Neurol. 24, 98\u2013105 (2024).","journal-title":"Pract. Neurol."},{"key":"40311_CR2","first-page":"178","volume":"155","author":"MB Jacobs","year":"1991","unstructured":"Jacobs, M. B. & Wasserstein, P. H. Spontaneous intracranial hypotension. An uncommon and underrecognized cause of headache. West. J. Med. 155, 178\u2013180 (1991).","journal-title":"West. J. Med."},{"key":"40311_CR3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2021.118069","volume":"430","author":"S Knodel","year":"2021","unstructured":"Knodel, S. et al. Sonographic and ophthalmic assessment of optic nerve in patients with idiopathic intracranial hypertension: A longitudinal study. J. Neurol. Sci. 430, 118069 (2021).","journal-title":"J. Neurol. Sci."},{"key":"40311_CR4","doi-asserted-by":"publisher","first-page":"2447","DOI":"10.1007\/s10072-019-04015-x","volume":"40","author":"P Lochner","year":"2019","unstructured":"Lochner, P. et al. Optic nerve sheath diameter: present and future perspectives for neurologists and critical care physicians. Neurol Sci 40, 2447\u20132457 (2019).","journal-title":"Neurol Sci"},{"key":"40311_CR5","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1007\/s00134-018-5305-7","volume":"44","author":"C Robba","year":"2018","unstructured":"Robba, C. et al. Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: A systematic review and meta-analysis. Intensive Care Med. 44, 1284\u20131294 (2018).","journal-title":"Intensive Care Med."},{"key":"40311_CR6","first-page":"195","volume":"56","author":"A Be\u015fir","year":"2019","unstructured":"Be\u015fir, A., Tertemiz, O. F., Akdo\u011fan, A. & Duman, E. N. The importance of optic nerve sheath diameter in post-dural puncture headache diagnosis and follow-up. Noro Psikiyatr. Ars. 56, 195\u2013199 (2019).","journal-title":"Noro Psikiyatr. 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It was conducted at the Neurology Department of a University Hospital. The local ethics committee (Ethikkommission der \u00c4rztekammer des Saarlandes; no. 208\/23) approved the study. All procedures were according to the ethical standards of the committee responsible for human experimentation (institutional and national) and the Helsinki Declaration of 1975, revised in 2013. Written informed consent was obtained from each participant or legal guardian.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"7468"}}