Rabies Encephalitis and the Use of Optic Nerve Sheath Diameter to Detect Elevated Intracranial Pressure

Authors

Dan Arreaza Kaufman, Ophthalmology, New York Medical College - Jamaica Hospital Medical Center, New York, USA.
Eva Teng, Ophthalmology, New York Medical College - Jamaica Hospital Medical Center, New York, USA.
Nicolas Biro, Ophthalmology, New York Medical College - Jamaica Hospital Medical Center, New York, USA.

Author Type(s)

Faculty

Journal Title

Cureus

First Page

e32154

Document Type

Article

Publication Date

12-1-2022

Department

Ophthalmology

Abstract

Rabies is a rare but rapidly progressive and almost universally fatal disease. A previously healthy 59-year-old male presented with rabies encephalitis. We measured his optic nerve sheath diameter (ONSD) daily in both eyes using ultrasonography to indirectly monitor for elevated intracranial pressure (ICP). We performed CT and MRI brain on days when his ONSD changed significantly. An increase in ONSD temporally correlated with radiologic findings of cerebral edema and acute subarachnoid hemorrhage (SAH). ONSD measurement is a fast, inexpensive, and widely-available imaging modality that may serve as a surrogate marker for elevated ICP. It may be especially useful in patients who are difficult to be transported to radiology due to the unstable nature of their disease.

Recommended Citation

Arreaza Kaufman, D., Teng, E., & Biro, N. (2022). Rabies Encephalitis and the Use of Optic Nerve Sheath Diameter to Detect Elevated Intracranial Pressure. Cureus, 14 (12), e32154. https://doi.org/10.7759/cureus.32154