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Background and Purpose: Transorbital sonography (TOS) provides a noninvasive tool to detect intracranial pressure by assessing optic nerve sheath diameter (ONSD) and optic disc elevation (ODE). The utility of TOS in the diagnosis of idiopathic intracranial hypertension (IIH) has been increasingly recognized. Methods: A single‐center case‐control study sought to compare TOS‐acquired ONSD and ODE among IIH‐cases versus patients with other neurological diseases (controls). Furthermore, a systematic review and meta‐analysis was conducted to present pooled mean differences and diagnostic measures of ONSD and ODE between IIH‐cases and controls. Results: In the single‐center study, consisting of 31 IIH‐cases and 34 sex‐ and age‐matched controls, ONSD values were higher among IIH‐cases than controls (p<.001), while ODE was more prevalent in cases (65% vs. 15%; p<.001). The receiver‐operating characteristic (ROC)‐curve analysis revealed that the optimal cutoff value of ONSD for predicting IIH was 5.15 mm, with an area under the curve (AUC) of 0.914 (95% confidence interval [CI]: 0.861‐0.967) and sensitivity and specificity values of 85% and 90%, respectively. In a meta‐analysis of 14 included studies with 415 IIH‐cases, ONSD and ODE values were higher in IIH‐cases than controls (mean difference in ONSD 1.20 mm; 95% CI: 0.96‐1.44 mm and in ODE 0.3 mm; 95% CI: 0.33‐0.67 mm). With regard to ONSD, pooled sensitivity, specificity, and diagnostic odds ratio were calculated at 85.5% (95% CI: 77.9‐90.8%), 90.7% (95% CI: 84.6‐94.5%), and 57.394 (95% CI: 24.597‐133.924), respectively. The AUC in summary ROC‐curve analysis was 0.878 (95% CI: 0.858‐0.899) with an optimal cutoff point of 5.0 mm. Conclusions: TOS has a high diagnostic utility for the noninvasive diagnosis of IIH and may deserve wider implementation in everyday clinical practice. [ABSTRACT FROM AUTHOR]

Objectives - Multiple Sclerosis (MS) has been linked with the presence of coronary artery disease including Acute Coronary Syndrome with Normal Coronary Arteries (ACSNCA), but limited data exist regarding the underlying mechanisms. We aimed to explore potential classic risk factors and novel vascular biomarkers related to ACSNCA in MS patients. Methods - One hundred six patients with MS were enrolled. Two groups were defined according to the presence and/or history of ACSNCA. The presence of predisposing factors such as hypertension, diabetes, hyperlipidemia, smoking, obesity and family history was reported. Arterial stiffness and aortic wave reflections were also assessed by pulse wave velocity (PWV) and augmentation index, respectively, calculated by a validated, brachial cuff-based automated oscillometric device. Multiple logistic regression models were constructed to determine the strongest parameters related with the presence of ACSNCA. Results - Eleven patients with episodes of ACSNCA (Group-A) and 95 MS patients free of ACSNCA (Group-B) were identified. Among blood pressure parameters (peripheral and aortic), arterial stiffness and wave reflections, PWV had the strongest independent association with ACSNCA (enter-method). PWV values above 7 m/sec were related with the history of ACSNCA independently from age, diabetes and blood pressure. When all hemodynamic, arterial and classic risk factors were examined in a step-wise (backward) model diabetes and hyperlipidemia were the strongest independent factors associated with ACSNCA's presence. Conclusions - In MS patients, diabetes and hyperlipidemia represent the strongest, independent parameters related with the presence of ACSNCA. Arterial stiffness seems to play an underlying role in the development of ACSNCA which merits further investigation. [ABSTRACT FROM AUTHOR]