Association of Optic Nerve Sheath Diameter in Ocular Ultrasound with Prognosis in Patients Presenting with Acute Stroke Symptoms

Overview

Journal Turk J Emerg Med

Specialty Emergency Medicine

Date 2019 Nov 6

PMID 31687611

Citations 5

Authors

Javad Seyedhosseini

Mehrad Aghili

Elnaz Vahidi

Farzaneh Shirani

Affiliations

Soon will be listed here.

Abstract

Background: Measurement of optic nerve sheath diameter (ONSD) by means of ocular ultrasound (US), can diagnose elevated intracranial pressure (ICP). Stroke accompanied by elevated ICP might have a worse prognosis.

Objective: To determine the relationship of ONSD in ocular US with prognosis in acute stroke in the emergency department (ED).

Methods: Patients with acute presentations of stroke, presenting to the ED in 2017 (during six months), were enrolled in our study. US exam was performed on all of them and ONSD was determined in two longitudinal and transverse dimensions. Demographic data, rate of patients' admission in the ward or intensive care unit, one-month patients' outcome and type of stroke were recorded. The relationship of mean ONSD was evaluated with study variables.

Results: In this study, 60 patients were enrolled. The mean ± SD ONSD in the deceased cases was 4.40 ± 0.64 mm and in the survived patients was 3.83 ± 0.56 mm. Youden index calculated ONSD>3.9 mm as the best cut-off point in mortality prognosis. It has a sensitivity of 83.3% and a specificity of 59.2%.

Conclusions: Increased ONSD had a direct relationship with mortality rate in acute stroke.

Citing Articles

Prognostic Value of Optic Nerve Sheath Diameters after Acute Ischemic Stroke According to Slice Thickness on Computed Tomography.

Lee H, Oh S, Jang J, Koo J, Bang H, Lee M Diagnostics (Basel). 2024; 14(16).

PMID: 39202242 PMC: 11354098. DOI: 10.3390/diagnostics14161754.

Dilated optic nerve sheath by ultrasound predicts mortality among patients with acute intracerebral hemorrhage.

Dias F, Zanon Zotin M, Alessio-Alves F, Martins Filho R, Barreira C, Vincenzi O Arq Neuropsiquiatr. 2023; 81(10):861-867.

PMID: 37939718 PMC: 10631847. DOI: 10.1055/s-0043-1775885.

Ultrasonic optic nerve sheath diameter could improve the prognosis of acute ischemic stroke in the intensive care unit.

Li C, Wang C, Meng Y, Fan J, Zhang J, Wang L Front Pharmacol. 2023; 13:1077131.

PMID: 36618944 PMC: 9816399. DOI: 10.3389/fphar.2022.1077131.

Optic nerve sheath diameter in patients with hepatic encephalopathy.

Colak N, Bayrak Basakci O, Bayram B, Aksay E, Kursat Simsek M, Karabay N PLoS One. 2022; 17(11):e0277643.

PMID: 36383620 PMC: 9668157. DOI: 10.1371/journal.pone.0277643.

Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes.

Patel R, Chowdhury M, Gul S, Fahy B, Gonzalez A, Fitzpatrick D Crit Care Explor. 2021; 3(11):e0565.

PMID: 34841250 PMC: 8613366. DOI: 10.1097/CCE.0000000000000565.

References

Lochner P, Leone M, Coppo L, Nardone R, Zedde M, Cantello R . B-mode transorbital ultrasononography for the diagnosis of acute optic neuritis. A systematic review. Clin Neurophysiol. 2015; 127(1):803-809. DOI: 10.1016/j.clinph.2015.05.005. View

Ropper A, Shafran B . Brain edema after stroke. Clinical syndrome and intracranial pressure. Arch Neurol. 1984; 41(1):26-9. DOI: 10.1001/archneur.1984.04050130032017. View

Stein D, Hu P, Brenner M, Sheth K, Liu K, Xiong W . Brief episodes of intracranial hypertension and cerebral hypoperfusion are associated with poor functional outcome after severe traumatic brain injury. J Trauma. 2011; 71(2):364-73. DOI: 10.1097/TA.0b013e31822820da. View

Gokcen E, Caltekin I, Savrun A, Korkmaz H, Savrun S, Yildirim G . Alterations in optic nerve sheath diameter according to cerebrovascular disease sub-groups. Am J Emerg Med. 2017; 35(11):1607-1611. DOI: 10.1016/j.ajem.2017.04.073. View

Geeraerts T, Launey Y, Martin L, Pottecher J, Vigue B, Duranteau J . Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury. Intensive Care Med. 2007; 33(10):1704-11. DOI: 10.1007/s00134-007-0797-6. View

Blaivas M, Theodoro D, Sierzenski P . Elevated intracranial pressure detected by bedside emergency ultrasonography of the optic nerve sheath. Acad Emerg Med. 2003; 10(4):376-81. DOI: 10.1111/j.1553-2712.2003.tb01352.x. View

Bauerle J, Lochner P, Kaps M, Nedelmann M . Intra- and interobsever reliability of sonographic assessment of the optic nerve sheath diameter in healthy adults. J Neuroimaging. 2010; 22(1):42-5. DOI: 10.1111/j.1552-6569.2010.00546.x. View

Jauch E, Saver J, Adams Jr H, Bruno A, Connors J, Demaerschalk B . Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013; 44(3):870-947. DOI: 10.1161/STR.0b013e318284056a. View

Morgenstern L, Hemphill 3rd J, Anderson C, Becker K, Broderick J, Connolly Jr E . Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010; 41(9):2108-29. PMC: 4462131. DOI: 10.1161/STR.0b013e3181ec611b. View

10.

Kernan W, Ovbiagele B, Black H, Bravata D, Chimowitz M, Ezekowitz M . Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014; 45(7):2160-236. DOI: 10.1161/STR.0000000000000024. View

11.

Hacke W, Schwab S, Horn M, Spranger M, De Georgia M, von Kummer R . 'Malignant' middle cerebral artery territory infarction: clinical course and prognostic signs. Arch Neurol. 1996; 53(4):309-15. DOI: 10.1001/archneur.1996.00550040037012. View

12.

Maude R, Hossain M, Hassan M, Osbourne S, Sayeed K, Karim M . Transorbital sonographic evaluation of normal optic nerve sheath diameter in healthy volunteers in Bangladesh. PLoS One. 2013; 8(12):e81013. PMC: 3846670. DOI: 10.1371/journal.pone.0081013. View

13.

Vik A, Nag T, Fredriksli O, Skandsen T, Moen K, Schirmer-Mikalsen K . Relationship of "dose" of intracranial hypertension to outcome in severe traumatic brain injury. J Neurosurg. 2008; 109(4):678-84. DOI: 10.3171/JNS/2008/109/10/0678. View

14.

Frattalone A, Stevens R . Intracranial pressure and its surrogates. Intensive Care Med. 2011; 37(7):1051-3. DOI: 10.1007/s00134-011-2226-0. View

15.

Shirodkar C, Munta K, Rao S, Mahesh M . Correlation of measurement of optic nerve sheath diameter using ultrasound with magnetic resonance imaging. Indian J Crit Care Med. 2015; 19(8):466-70. PMC: 4548416. DOI: 10.4103/0972-5229.162465. View

16.

Hawthorne C, Piper I . Monitoring of intracranial pressure in patients with traumatic brain injury. Front Neurol. 2014; 5:121. PMC: 4100218. DOI: 10.3389/fneur.2014.00121. View

17.

Chen H, Ding G, Zhao Y, Yu R, Zhou J . Ultrasound measurement of optic nerve diameter and optic nerve sheath diameter in healthy Chinese adults. BMC Neurol. 2015; 15:106. PMC: 4493801. DOI: 10.1186/s12883-015-0361-x. View

18.

Goeres P, Zeiler F, Unger B, Karakitsos D, Gillman L . Ultrasound assessment of optic nerve sheath diameter in healthy volunteers. J Crit Care. 2015; 31(1):168-71. DOI: 10.1016/j.jcrc.2015.10.009. View