Should Acetazolamide Be the First-Line Treatment for Patients With Idiopathic Intracranial Hypertension?

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Title Should Acetazolamide Be the First-Line Treatment for Patients With Idiopathic Intracranial Hypertension?
Creator David I. Kaufman, DO; Deborah I. Friedman, MD, MPH
Affiliation Department of Neurology and Ophthalmology (DK), Michigan State University, East Lansing, Michigan; and Departments of Neurology and Neurotherapeutics and Ophthalmology (DF), University of Texas Southwestern Medical Center, Dallas, Texas.
Abstract Clinical orbital MRI protocols are routinely used to study the optic nerves and exclude compressive lesions, infarctions, or inflammation. However, the small caliber and divergent oblique orientations of the optic nerves make it challenging to characterize them well with conventional MRI, especially since adjacent air-filled bony structures distort the MRI signal and motion is a problem even in cooperative, healthy volunteers. Over the past 3 years we have experimented with multiple novel MRI approaches and sequences to better characterize the optic nerves. The perfect MRI protocol would be quantitative and sensitive to subtle optic nerve pathologic changes, provide high spatial resolution, be rapidly acquired, and resistant to motion degradation. This review provides an update of recent MRI sequence innovations for the optic nerves being currently translated into clinical practice. Methods discussed include rapid MRI with compressed sensing or simultaneous multislice approaches, postprocessing techniques for quantitative T2 mapping or track density imaging, and multiple MRI sequences for measuring diffusion in the optic nerves. Recently-developed orbit-specific MRI coils, quantitative sequences, and rapid acquisition techniques can improve our future ability to study optic nerve pathologies noninvasively. As advanced MRI becomes more proficient at characterizing the optic nerves, its role in the clinical management of patients should increase.
Subject Acetazolamide / therapeutic use; Carbonic Anhydrase Inhibitors / therapeutic use; Decision Making; Humans; Intracranial Pressure / drug effects; Magnetic Resonance Imaging; Papilledema / diagnosis; Papilledema / drug therapy; Papilledema / etiology; Pseudotumor Cerebri / complications; Pseudotumor Cerebri / diagnosis; Pseudotumor Cerebri / drug therapy; Treatment Outcome
OCR Text Show
Date 2017-06
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6w13cmp
Setname ehsl_novel_jno
ID 1364491
Reference URL https://collections.lib.utah.edu/ark:/87278/s6w13cmp
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