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

Gökçen, Emre; Çalteki̇n, İbrahi̇m; Savrun, Atakan; Korkmaz, Hilal; Savrun, Şeyda Tuba; Yıldırım, Gökhan

doi:10.1016/j.ajem.2017.04.073

Cited by 22 publications

(23 citation statements)

References 19 publications

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“…The clinical role of ONSD based noninvasive measurements of ICP in ischemic stroke is increasingly gathering attention. In previous literatures, it has been shown that ONSD increases in early ischemic stroke compared to normal controls [ 36 ]. In ischemic stroke subtypes, a total anterior circulation infarct type was associated with elevations in ONSD compared to control and other stroke subtypes [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…In previous literatures, it has been shown that ONSD increases in early ischemic stroke compared to normal controls [ 36 ]. In ischemic stroke subtypes, a total anterior circulation infarct type was associated with elevations in ONSD compared to control and other stroke subtypes [ 36 ]. It has been further shown that ONSD can differentiate ischemic stroke and hemoarrhagic stroke with moderate predictive power [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

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Optic nerve sheath diameter change in prediction of malignant cerebral edema in ischemic stroke: an observational study

et al. 2020

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Background In acute large anterior circulation infarct patients with large core volume, we evaluated the role of optic nerve sheath diameter (ONSD) change rates in prediction of malignant progression. Methods We performed a retrospective observational study including patients with anterior circulation acute ischemic stroke with large ischemic cores from January 2010 to October 2017. Primary outcome was defined as undergoing decompressive surgery or death due to severe cerebral edema, and termed malignant progression. Patients were divided into malignant progressors and nonprogressors. Malignant progression was divided into early progression that occurred before D1 CT, and late progression that occurred afterwards. Retrospective analysis of changes in mean ONSD/eyeball transverse diameter (ETD) ratio, and midline shifting (MLS) were evaluated on serial computed tomography (CT). Through analysis of CT at baseline, postprocedure, and at D1, the predictive ability of time based change in ONSD/ETD ratio in predicting malignant progression was evaluated. Results A total of 58 patients were included. Nineteen (32.8%) were classified as malignant; 12 early, and 7 late progressions. In analysis of CTpostprocedure, A 1 mm/hr. rate of change in MLS during the CTbaseline-CTpostprocedure time phase lead to a 6.7 fold increased odds of early malignant progression (p < 0.05). For ONSD/ETD, 1%/hr. change lead to a 1.6 fold increased odds, but this association was trending (p = 0.249). In the CTD1, 1%/day change of ONSD/ETD in the CTbaseline-CTD1 time phase lead to a 1.4 fold increased odds of late malignant progression (p = 0.021) while 1 mm/day rate of change in MLS lead to a 1.5 fold increased odds (p = 0.014). Conclusions The rate of ONSD/ETD changes compared to baseline at D1 CT can be a predictor of late malignant progression along with MLS. ONSD/ETD change rates evaluated at postprocedure did not predict early malignant progression.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Optic nerve sheath diameter change in prediction of malignant cerebral edema in ischemic stroke: an observational study

et al. 2020

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“…Skoloudlik et al 11 found significantly enlarged ONSD in acute ICH patients compared to ischemic stroke patients, and the best cut-off point to predict ICH volume >2.5 cm 3 was relative ONSD enlargement of >0.66 mm. Göcken et al 12 evaluated ONSD in ischemic stroke patients according to 4 Oxfordshire Community Stroke Project subgroups and found the highest right-left ONSD in the total anterior circulation infarction (TACI) group. Our study included only two ischemic stroke patients suspected to have raised ICP due to middle cerebral artery infarction, which is actually TACI group, having mean ONSD of 6.28+0.87 mm.…”

Section: Discussionmentioning

confidence: 99%

“…Göcken et al . ( 12 ) evaluated ONSD in ischemic stroke patients according to 4 Oxfordshire Community Stroke Project subgroups and found the highest right-left ONSD in the total anterior circulation infarction (TACI) group. Our study included only two ischemic stroke patients suspected to have raised ICP due to middle cerebral artery infarction, which is actually TACI group, having mean ONSD of 6.28 + 0.87 mm.…”

Section: Discussionmentioning

confidence: 99%

“…Transorbital ultrasonography has been demonstrated to be a reliable bedside technique for noninvasive detection of elevated ICP in TBI ( 4 - 7 ), post resuscitation syndrome ( 8 ), or infection. It was shown to be a useful tool in the assessment of patients with primary or secondary idiopathic intracranial hypertension ( 9 ), intracranial hypotension ( 10 ), and in two studies it was used in the assessment of stroke patients ( 11 , 12 ). It was employed to monitor patients after placement of an extraventricular drain in subarachnoid hemorrhage (SAH) and acute hydrocephalus, but no relevant decline of ONSD could be measured over time ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

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Optic Nerve Sheath Sonography Is a Promising Tool for Assessment of Raised Intracranial Pressure in Patients Admitted to Neurological Intensive Care Unit

2020

ACC

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-Optic nerve sheath diameter (ONSD) enlargement is detectable in traumatic brain injury patients with raised intracranial pressure (ICP). The aim was to assess its value in neurological patients suspected to have increased ICP. Patient clinical imaging data and hospitalization outcome were analyzed. Patients were divided into groups according to brain pathology and level of consciousness with Glasgow Coma Score (GCS). Poor hospitalization outcome was assessed by modified Rankin scale (mRS) >3. Data obtained by ocular sonography performed in acute setting were compared with data of 100 control subjects. Data were expressed as mean ± SD. Intergroup comparison was performed by Student's t-test. Data of 34 patients (63+16 years) were suitable for analysis, including 8 primary intracerebral hemorrhage (PICH), 8 subarachnoid hemorrhage (SAH), 12 PICH or SAH and intraventricular hemorrhage (IVH), 4 tumors and 2 ischemic strokes. The mean ONSD was 5.86+0.69 mm in patients versus 4.38+0.41 mm in controls (p<0.01). ONSD was 6.28+0.61 mm in patients with GCS <8 and 5.77+0.55 mm in other patients (p<0.05). ONSD was 5.72+0.59 mm in PICH versus 6.20+0.65 mm in PICH/SAH with IVH (p=0.1). ONSD was 5.73+0.38 mm in SAH in comparison to PICH/SAH with IVH (p=0.05). There was no statistically significant difference in optic nerve diameter between patients and controls (2.48+0.28 mm vs. 2.39+0.33 mm; p>0.05). Pronounced enlargement of ONSD was observed in patients with ICH or SAH with IVH, and in patients with GCS <8. Enlarged ONSD was associated with poor neurological outcome (mRS >3).

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Optic Nerve Sheath Diameter for Increased Intracranial Pressure

Hunt¹

2022

Neurovascular Sonography

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

Cited by 22 publications

References 19 publications

Optic nerve sheath diameter change in prediction of malignant cerebral edema in ischemic stroke: an observational study

Optic nerve sheath diameter change in prediction of malignant cerebral edema in ischemic stroke: an observational study

Optic Nerve Sheath Sonography Is a Promising Tool for Assessment of Raised Intracranial Pressure in Patients Admitted to Neurological Intensive Care Unit

Optic Nerve Sheath Diameter for Increased Intracranial Pressure

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