Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes

Overview

Journal Crit Care Explor

Specialty Critical Care

Date 2021 Nov 29

PMID 34841250

Citations 1

Authors

Rohit Patel

Muhammad A B Chowdhury

Sarah Gul

Brenda G Fahy

Andres Gonzalez

Desmond Fitzpatrick

Giuliano DePortu

Emily Weeks

Marie-Carmelle Elie-Turenne

Samirah Ocampo

Sameer Ponnaluri

Michael A Pizzi

Affiliations

Soon will be listed here.

Abstract

Design: Single-center prospective observational study.

Setting: Emergency department and ICUs.

Patients: Patients suspected of stroke.

Interventions: None.

Measures And Main Results: Bilateral optic nerve sheath diameter was measured on arrival and within the first 2 days of admission. Outcomes were inpatient survival, Cerebral Performance Category, and modified Rankin Scale at 3 and 6 months. Analysis was conducted using descriptive statistics, paired test, chi-square test. Eighty-six patients were enrolled with ischemic or hemorrhagic stroke. Mean age was 67.2 years (± 15 yr), and 54.7% of patients were male. There was no difference between left and right eye measurements ( = 0.467 and = 0.903, respectively) or between longitudinal and transverse measurements (transverse = 0.163 and longitudinal = 0.270). Mean optic nerve sheath diameter differed in patients who survived versus died prior to discharge in both ischemic (0.53 vs 0.58 cm; = 0.009) or hemorrhagic stroke (0.57 vs 0.62 cm; = 0.019). For every 0.1 cm increase in optic nerve sheath diameter, odds ratio for death were 4.2 among ischemic stroke (95% CI, 1.32-13.64; = 0.015), and odds ratio 6.2 among ischemic or hemorrhagic patients (95% CI, 1.160-33.382; = 0.033). Increased optic nerve sheath diameter correlated ( = 0.44; < 0.0001) with poor functional outcomes measured as modified Rankin Scale scores of 3-6 at 6 months.

Conclusions: Elevations in optic nerve sheath diameter were associated with increased inhospital mortality and poor functional outcome at 6 months. Optic nerve sheath diameter may serve as a noninvasive marker of inhospital mortality and functional outcome. Further multicenter prospective trials for evaluating and treating optic nerve sheath diameter in ischemic and hemorrhagic strokes are warranted.

Citing Articles

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.

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