Measuring the Optic Nerve Sheath Diameter with Ultrasound in Acute Middle Cerebral Artery Stroke Patients
Copyright © 2020 Elsevier Inc. All rights reserved..
BACKGROUND: Measurement of the optic nerve sheath diameter (ONSD) with ultrasound enables non-invasive and indirect assessment of increased intracranial pressure (ICP). Although most of the studies were employed with traumatic brain injury patients, it's increasingly popular in acute ischemic stroke (AIS) studies.
OBJECTIVES: Evaluating whether using ONSD as a follow-up measurement would help monitor the thrombolytic therapy (TT) effectiveness and determine the high-risk patients for malignant middle cerebral artery (MCA) syndrome.
METHODS: This prospective observational study was conducted between August 1, 2019, and February 1, 2020, in a tertiary hospital. Forty-four patients were eligible. We determined the TT moment as the time when the first ocular ultrasound measurement would be made (time 0). Also, we decided on the 24th h after the treatment as the time to perform the second ocular ultrasound measurement (time 24). The National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Alberta Stroke Program Early Computed Tomography (ASPECT) scores were evaluated blindly at the time-0 and the time-24. The cut-off value of ONSD was 0.55 mm.
RESULTS: There was no difference in ONSD results before and after the TT (p = 0.414). But, patients with an equal or higher value than cut-off had an increased risk for complications such as malignant-MCA, bleeding, seizure, etc. (p = 0.05). Malignant-MCA was observed in four patients with higher ONSD values. At the time-24, NIHSS decreased, GCS and ASPECT scores increased. Finally, ONSD was positively correlated with the NIHSS and negatively correlated with the GCS at the time-24.
CONCLUSIONS: Monitoring ONSD values in both the emergency department and the intensive care unit may be useful in the early diagnosis of MCA stroke complications and the follow-up of TT's effectiveness.
| Errataetall: |
CommentIn: J Stroke Cerebrovasc Dis. 2021 Apr;30(4):105619. - PMID 33483234 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association - 30(2021), 2 vom: 20. Feb., Seite 105523 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Güzeldağ, Seda [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 25.01.2021 Date Revised 27.05.2021 published: Print-Electronic CommentIn: J Stroke Cerebrovasc Dis. 2021 Apr;30(4):105619. - PMID 33483234 Citation Status MEDLINE |
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| doi: |
10.1016/j.jstrokecerebrovasdis.2020.105523 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM318726106 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Stroke Cerebrovasc Dis. 2021 Apr;30(4):105619. - PMID 33483234 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Measurement of the optic nerve sheath diameter (ONSD) with ultrasound enables non-invasive and indirect assessment of increased intracranial pressure (ICP). Although most of the studies were employed with traumatic brain injury patients, it's increasingly popular in acute ischemic stroke (AIS) studies | ||
| 520 | |a OBJECTIVES: Evaluating whether using ONSD as a follow-up measurement would help monitor the thrombolytic therapy (TT) effectiveness and determine the high-risk patients for malignant middle cerebral artery (MCA) syndrome | ||
| 520 | |a METHODS: This prospective observational study was conducted between August 1, 2019, and February 1, 2020, in a tertiary hospital. Forty-four patients were eligible. We determined the TT moment as the time when the first ocular ultrasound measurement would be made (time 0). Also, we decided on the 24th h after the treatment as the time to perform the second ocular ultrasound measurement (time 24). The National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Alberta Stroke Program Early Computed Tomography (ASPECT) scores were evaluated blindly at the time-0 and the time-24. The cut-off value of ONSD was 0.55 mm | ||
| 520 | |a RESULTS: There was no difference in ONSD results before and after the TT (p = 0.414). But, patients with an equal or higher value than cut-off had an increased risk for complications such as malignant-MCA, bleeding, seizure, etc. (p = 0.05). Malignant-MCA was observed in four patients with higher ONSD values. At the time-24, NIHSS decreased, GCS and ASPECT scores increased. Finally, ONSD was positively correlated with the NIHSS and negatively correlated with the GCS at the time-24 | ||
| 520 | |a CONCLUSIONS: Monitoring ONSD values in both the emergency department and the intensive care unit may be useful in the early diagnosis of MCA stroke complications and the follow-up of TT's effectiveness | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Middle Cerebral Artery Infarction | |
| 650 | 4 | |a Optic Nerve Sheath Diameter | |
| 650 | 4 | |a Stroke | |
| 650 | 4 | |a Thrombolytic Therapy | |
| 700 | 1 | |a Yılmaz, Gökhan |e verfasserin |4 aut | |
| 700 | 1 | |a Tuna, Merva |e verfasserin |4 aut | |
| 700 | 1 | |a Altuntaş, Mükerrem |e verfasserin |4 aut | |
| 700 | 1 | |a Özdemir, Mustafa |e verfasserin |4 aut | |
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