Episode 26 – Ocular Ultrasound with Chris Fox
So we just finished maybe the most amazing week of our lives (besides our wedding and babies’ birth – We love you wives if you’re reading this!) Castlefest is over, and we’ve got some special Castlefest footage for you. Chris Fox is coming into your earbuds this month to teach you about Ocular ultrasound. And yes, I know Castlefest has just ended, but we don’t like to live in the past.
…We’ve got a special announcement today… ALASKAFEST 2012! I’d tell you about it right now, but why don’t you just watch the episode and we explain everything fully at the end. We’ve got room for about 1/4th (25% in old money) of the people we had at Castlefest, so don’t get mad at us if it’s full. Registration is open now.
p.s. – audio for this episode isn’t perfect as it’s recorded from a lapel mic at Castlefest, but it’s Chris Fox people, so quit your complaining…….
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I used this technique just last week to confirm an elevated ICP reading by a Codman. I didn’t have a Tegaderm handy, so I just cut a large latex glove into sort of a square sheet which I draped over the patient’s closed eye, and then applied ultrasound gel over the latex, leaving the eye completely residue free. Perfect images. Great podcast!
Can elevated ICP measurements for TBI be applied to patients with idiopathic intracranial hypertension?
Probably…..
The numbers are small but there is some evidence that yes, it can. Here is a case report by Mike Stone (http://www.slredultrasound.com/Filesandpictures/Optic4.pdf)
Here is a small study in the Journal of Neurology that is positive on the question: http://www.ncbi.nlm.nih.gov/pubmed/21523461
We need bigger studies, but probably yes. In my practice I had someone who I suspected it in recently, but they refused an LP. They were willing to let me do the ultrasound and while I told them I couldn’t rule it out, I did feel better about their normal result. If it had been positive, then I could have used that to help me push them towards the LP.