Seyedhosseini Javad, Aghili Mehrad, Vahidi Elnaz, Shirani Farzaneh
Tehran University of Medical Sciences, Shariati Hospital, Emergency Medicine Research Center, Prehospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Emergency Medicine Resident, Tehran University of Medical Sciences, Shariati Hospital, Emergency Medicine Research Center, Iran.
Turk J Emerg Med. 2019 Jul 16;19(4):132-135. doi: 10.1016/j.tjem.2019.07.001. eCollection 2019 Oct.
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.
To determine the relationship of ONSD in ocular US with prognosis in acute stroke in the emergency department (ED).
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.
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%.
Increased ONSD had a direct relationship with mortality rate in acute stroke.
通过眼部超声（US）测量视神经鞘直径（ONSD）可诊断颅内压（ICP）升高。伴有ICP升高的中风可能预后更差。
确定急诊科（ED）急性中风患者眼部超声检查中ONSD与预后的关系。
纳入2017年（六个月内）在ED就诊的急性中风患者。对所有患者进行超声检查，并在两个纵向和横向维度上确定ONSD。记录人口统计学数据、患者入住病房或重症监护病房的比例、患者一个月的预后情况以及中风类型。评估平均ONSD与研究变量之间的关系。
本研究共纳入60例患者。死亡病例的平均±标准差ONSD为4.40±0.64mm，存活患者为3.83±0.56mm。约登指数计算得出ONSD>3.9mm为死亡率预后的最佳切点。其灵敏度为83.3%，特异度为59.2%。
急性中风患者ONSD升高与死亡率直接相关。
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