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Abstract
Objective: To monitor the changes in optic nerve sheath diameter (ONSD) induced by acute exposure to hypobaric hypoxia and to investigate factors associated with these changes, including development of acute mountain sickness.
Methods: In this cohort study, neurologic signs and symptoms, cardiovascular parameters, and ultrasonography of ONSD were prospectively assessed in 19 healthy lowlanders at baseline and after ascent to 3,830 m (3 hours, 9 hours, 24 hours, 48 hours, 72 hours, and 8 days) by blinded investigators. Potential confounding factors (e.g., altitude variations, physical effort) were minimized. A multivariate analysis of factors associated with ONSD was performed by means of generalized estimating equations.
Results: ONSD increased with exposure to altitude in all participants (p < 0.001). The increase between 9 and 24 hours was larger in patients who developed acute mountain sickness (p = 0.001). There was no influence of sex, oxygen saturation, or acclimatization on ONSD.
Conclusion: Both physiologic and pathologic responses to hypobaric hypoxia were independently associated with changes in ONSD. Studies on a larger cohort, at a range of altitudes, and with baseline neuroimaging techniques are necessary to further understand the clinical significance of increased ONSD during exposure to hypobaric hypoxia.
GLOSSARY
- AMS=
- acute mountain sickness;
- BR=
- breathing rate;
- HR=
- heart rate;
- ICP=
- intracranial pressure;
- LLS=
- Lake Louise score;
- ONSD=
- optic nerve sheath diameter;
- Spo2=
- oxygen saturation
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received November 15, 2013.
- Accepted in final form February 25, 2014.
- © 2014 American Academy of Neurology
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