Association of optic nerve sheath diameter in ocular ultrasound with prognosis in patients presenting with acute stroke symptoms
Javad Seyedhosseini1, Mehrad Aghili2, Elnaz Vahidi3, Farzaneh Shirani4
1Tehran University of Medical Sciences, Shariati Hospital, Emergency Medicine Research Center, Prehospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
2Emergency Medicine Resident, Tehran University of Medical Sciences, Shariati Hospital, Emergency Medicine Research Center, Iran
3Tehran University of Medical Sciences, Shariati Hospital, Emergency Medicine Research Center, Prehospital Emergency Research Center, Tehran University of Medical Sciences, Iran
4Tehran University of Medical Sciences, Shariati Hospital, Emergency Medicine Department, Iran
Keywords: Stroke, Optic nerve sheath diameter, Prognosis, Ultrasound
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.