Prevalence of Raised Intracranial Pressure in Cerebral Malaria Detected by Optic Nerve Sheath Ultrasound
Prevalence of Raised Intracranial Pressure in Cerebral Malaria Detected by Optic Nerve Sheath Ultrasound
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DOI：
10.4269/ajtmh.2012.11-0459
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发表时间：
2012-12-01
影响因子：
3.3
通讯作者：
Molyneux, Malcolm E.
中科院分区：
文献类型：
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作者：
Beare, Nicholas A. V.;Glover, Simon J.;Molyneux, Malcolm E.
我们的目标是使用视神经鞘(ONS)超声来确定患有脑型疟疾(CM)的非洲儿童的颅内压升高的患病率；以及ONS直径的增加是否与不良预后相关。我们测量了马拉维101名患有CM的儿童和11名患有疟疾和意识障碍的儿童的ONS直径。由ONS直径增大检测到的颅内压升高的发生率为49%。入院时ONS直径增大的儿童(9/55)和未增大ONS直径的儿童(11/57)的病死率相似。神经后遗症在ONS直径增大的儿童中更为常见(7/46比2/46，P<；0.05)。在接受腰椎穿刺术的46名儿童中，95%的儿童腰椎穿刺术(LP)开放压力升高。在患有CM的马拉维儿童中，ONS超声检测到的颅内压升高比LP少。这项研究表明，颅内压升高在CM中并不普遍，其他机制可能是昏迷的原因。
We aimed to use optic nerve sheath (ONS) ultrasound to determine the prevalence of raised intracranial pressure (ICP) in African children with cerebral malaria (CM); and if increased ONS diameter is associated with poor outcome. We measured ONS diameter in 101 children with CM and 11 children with malaria and impaired consciousness in Malawi. The prevalence of raised ICP detected by increased ONS diameter was 49%. Case fatality was similar in children with increased ONS diameter on admission (9/55) and those children without increased ONS diameter (11/57). Neurological sequelae were more common in those children with increased ONS diameter (7/46 versus 2/46, P < 0.05). Lumbar puncture (LP) opening pressure was elevated in 95% of 46 children who underwent LP. In Malawian children with CM, raised ICP is less commonly detected by ONS ultrasound than LP. This study suggests that raised ICP is not universal in CM and that other mechanisms may account for coma.