yavuz selim Divriklioglu Divriklioglu; onur karakayal?; Yavuz Yi?it; serkan yilmaz; Yavuz Birinci; Bora kalaycioglu
Volume 25, Issue 10 , 2023
Abstract
Introduction: Stroke is the leading cause of high mortality rates in the emergency department (ED). In this regard, early diagnosis and starting appropriate treatments are important. We aimed to evaluate the efficiency of the optic nerve sheath diameter (ONSD) in the detection of ischemic cerebrovascular ...
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Introduction: Stroke is the leading cause of high mortality rates in the emergency department (ED). In this regard, early diagnosis and starting appropriate treatments are important. We aimed to evaluate the efficiency of the optic nerve sheath diameter (ONSD) in the detection of ischemic cerebrovascular disease on initial brain computerized tomography (CT) images of patients presented with ischemic stroke clinic to ED.
Method: In this study, 375 retrospectively-evaluated patients underwent brain CT with a pre-diagnosis of cerebrovascular events, following diffusion magnetic resonance imaging (MRI) due to suspicion of ischemic stroke. Demographic findings, vital signs, Glasgow Coma Scale, National Institute of Health Stroke Scale, Modified Rankin Scale. The results of brain CT as well as diffusion magnetic resonance imaging (MRI) were noted. The measurement of ONSD was done at 3 mm behind the optic disc from both eyes from the initial brain CT of the patients.
Results: In this study, 198 out of 375 patients (52.8%) were women. The mean age of patients was obtained at 67.74±13.18 years. According to diffusion MRI, 143 (38.1%) patients experienced ischemic stroke. The mean age of patients with ischemic stroke was 68.75±12.26 years, and 80 (55.9%) patients were women. The mean scores of ONSD with ischemic stroke were 5.14±0.68 and 4.79±0.6 in the control group. In the diagnosis of ischemic stroke, there was a statistically significant difference between the patient and control groups in terms of ONSD.
Conclusion: In CT images of patients with ischemic stroke, ONSD values were found to increase. If ONSD measurement via brain CT correlates with physical examination and clinical signs, it can be used as an indicator in the diagnosis of early-term ischemic stroke.
Sinan Karacabey; Erkman Sanr?
Volume 24, Issue 10 , 2022
Abstract
Background: Head trauma may cause an increase in intracranial pressure (ICP). The use of ocular ultrasound to measure optic nerve sheath diameter (ONSD) is a method to determine the ICP. The use of the rigid cervical collar in head trauma patients contribute to elevating ICP, and therefore, potentially ...
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Background: Head trauma may cause an increase in intracranial pressure (ICP). The use of ocular ultrasound to measure optic nerve sheath diameter (ONSD) is a method to determine the ICP. The use of the rigid cervical collar in head trauma patients contribute to elevating ICP, and therefore, potentially causing further deterioration in their condition.
Objectives: This study aimed to describe changes in ONSD after the placement of a c-collar and analyze these changes depending on the time in the c-collar.
Methods: This prospective study measured the ONSD of minor head trauma patients before and after the placement of a c-collar. Patients aged ³18 with blunt head trauma and Glasgow Coma Score ³13 were included in the study. Each eye was scanned twice. This was done before c-collar placement, at 5 and 20 min after placement. The mean values of both eyes were calculated and analyzed.
Results: This study investigated 50 patients. The mean baseline ONSD was obtained at 4.71mm±0.22 (4.54-4.77). Furthermore, T5 and T20 measurements were 5.19±0.41 (5.07-5.31) and 5.26±0.45 (5.14-5.39), respectively. The ONSD increased at T5 and T20. The changes from the baseline measurements were statistically significant (P=0.000, P=0.000). The difference between T5 and T20 groups was an increase in ONSD, and these differences were also statistically significant (0.07±0.19; P=0.008).
Conclusion: Our results revealed that minor head trauma patients using a c-collar may increase ONSD by timeline the clinical effects of which have to be determined with further studies. Enlargement in ONSD should be considered when interpreting ICP.
