{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:21:05Z","timestamp":1782181265355,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,12,15]],"date-time":"2016-12-15T00:00:00Z","timestamp":1481760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2017,3]]},"abstract":"Background and purpose<\/jats:title>Cerebrospinal fluid (CSF) removal improves clinical symptoms of many patients with idiopathic normal\u2010pressure hydrocephalus (iNPH<\/jats:styled-content>). The aim of this study was to investigate the correlation of changes in the optic nerve sheath diameter (ONSD<\/jats:styled-content>) with patient responses to CSF<\/jats:styled-content> removal.<\/jats:p><\/jats:sec>Methods<\/jats:title>Transorbital ultrasonography was performed to obtain ONSD<\/jats:styled-content> measurements in 31 patients with iNPH<\/jats:styled-content> before and after lumbar puncture. Measurements were obtained while patients were supine and upright. Changes in the ONSD<\/jats:styled-content> between supine and upright positions [ONSD<\/jats:styled-content> variability (ONSD<\/jats:styled-content>\u2010V)] were assessed and compared with those in 60 healthy volunteers. ONSD<\/jats:styled-content>\u2010V was correlated with relative changes in a validated iNPH<\/jats:styled-content> severity (Boon) score.<\/jats:p><\/jats:sec>Results<\/jats:title>Mean pre\u2010puncture ONSD<\/jats:styled-content>\u2010V was significantly lower in healthy volunteers and patients with no response to CSF<\/jats:styled-content> removal (Fisher test) [0.05 \u00b1 0.14 mm (SD)<\/jats:styled-content>] than in responsive patients [0.37 \u00b1 0.20 mm (SD)<\/jats:styled-content>, P<\/jats:italic> < 0.001]. ONSD<\/jats:styled-content>\u2010V predicted response to the spinal tap test (odds ratio, 0.30; 95% confidence interval, 0.12\u20130.75 mm, P<\/jats:italic> = 0.011). The higher the ONSD<\/jats:styled-content>\u2010V, the better the therapeutic effect (\u03c7<\/jats:italic>2<\/jats:sup> = 14.980, P<\/jats:italic> < 0.001). The post\u2010spinal tap test ONSD<\/jats:styled-content>\u2010V correlated significantly with clinical severity in the motor portion of the Boon score [0.16 \u00b1 0.23 mm (SD<\/jats:styled-content>), P<\/jats:italic> = 0.003].<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The ONSD<\/jats:styled-content>\u2010V before and after spinal tap test correlated well with the clinical effects of CSF<\/jats:styled-content> removal. Transorbital ultrasonography seems to be a reliable, safe add\u2010on to the Fisher test and may support selection of patients for shunt intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.13225","type":"journal-article","created":{"date-parts":[[2016,12,17]],"date-time":"2016-12-17T12:41:22Z","timestamp":1481978482000},"page":"461-467","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Measuring changes in the optic nerve sheath diameter in patients with idiopathic normal\u2010pressure hydrocephalus: a useful diagnostic supplement to spinal tap tests"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7023-4190","authenticated-orcid":false,"given":"M.","family":"Ertl","sequence":"first","affiliation":[{"name":"Clinic for Neurology and Neurophysiology Klinikum Augsburg Augsburg 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