Alterations in optic nerve sheath diameter according to cerebrovascular disease sub-groups

• Published in: The American journal of emergency medicine 2017-11, Vol.35 (11), p.1607-1611
• Main Authors: Gökcen, Emre, Caltekin, İbrahim, Savrun, Atakan, Korkmaz, Hilal, Savrun, Şeyda Tuba, Yıldırım, Gökhan
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Brain Infarction - complications; Brain Infarction - diagnostic imaging; Cerebral infarction; Cerebrovascular disease; Cerebrovascular diseases; Cerebrovascular Disorders - classification; Cerebrovascular Disorders - complications; Cerebrovascular Disorders - diagnostic imaging; Classification; Computed tomography; Edema; Emergency; Emergency medical care; Emergency medical services; Emergency Service, Hospital; Eye; Female; Humans; Intracranial Hypertension - diagnostic imaging; Intracranial Hypertension - etiology; Intracranial Pressure; Ischemia; Male; Methods; Middle Aged; Morbidity; Optic nerve; Optic Nerve - diagnostic imaging; Optic Nerve - pathology; Optic nerve sheath diameter; Organ Size; Pressure; Retrospective Studies; Sensitivity and Specificity; Severity of Illness Index; Statistical analysis; Stroke; Stroke - classification; Stroke - complications; Stroke - diagnostic imaging; Stroke, Lacunar - complications; Stroke, Lacunar - diagnostic imaging; Tomography, X-Ray Computed; Traumatic brain injury; Ultrasonic imaging; Vascular diseases
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2017.04.073

Abstract Background ONSD (optic nerve sheath diameter) is a method used for indirect measurement of the increased intracranial pressure. In previous studies, the relation between the increased intracranial pressure and ONSD was analyzed in the patients suffering from cerebrovascular diseases (CVD). In our study, the patients suffering from ischemic CVD were categorized into 4 subgroups according to Oxfordshire Community Stroke Project classification (OCSP); the relationship between each group and ONSD, and the influence on each eye were analyzed. Methods The study included the patients over the age of 18 applying to the emergency department of Malatya State Hospital with the symptoms of stroke between the dates of 1/1/2015 and 1/9/2016. The patients diagnosed with stroke by means of clinical and neuroradiological imaging were examined in 4 subgroups according to Oxfordshire Community Stroke Project. The aim of the study is to predict the intracranial pressure (ICP) levels of the patients through ONSD measurement and CT images. Results In the comparison of the right and left optic nerve sheath diameters of CVD group and control group, the obtained results were found to be statistically significant ( p < 0.001). When the CVD subgroups were compared with the control group in terms of right and left optic nerve sheath diameters, the highest right-left optic nerve sheath diameter was detected to be in TACI (Total Anterior Circulation Infarction) group ( p < 0.001). Discussion/conclusion In the early cases of CVD, mortality and morbidity can be decreased through the early diagnosis of the possible existence of ICP increase according to ONSD level.