Sivas Erdem, Colak Nese, Bayram Basak, Simsek Muhammet Kursat, Karabay Nuri, Ozturk Vesile
Department of Emergency Medicine, Mardin Public Hospital, Mardin, Turkey.
Department of Emergency Medicine, University of Health Sciences Turkey, Izmir, Turkey.
PeerJ. 2025 Mar 31;13:e19197. doi: 10.7717/peerj.19197. eCollection 2025.
Intracranial pressure increases due to ischemic infarction caused by stroke. This study aimed to evaluate the pre-thrombolytic and post-thrombolytic optic nerve sheath diameter (ONSD) measurements in predicting clinical outcomes and complications for stroke patients.
ONSD was measured on computed tomography (CT) scans. The average ONSD (aONSD) was calculated from the right and left eyes. Pre-thrombolytic (ONSD-0) and post-thrombolytic (ONSD-24) values were compared according to right left eye, stroke-affected side of the brain, presence of complications, and mortality.
Ninety-three patients were enrolled; 52.7% were female, and the mean age of all participants was 76 years. The aONSD-24 values were higher than the aONSD-0 values (5.5 ± 0.7 mm and 5.3 ± 0.7 mm, respectively, < 0.001). There was no significant difference between right and left measurements (right ONSD-0 5.3 mm . left ONSD-0 5.3 mm, = 0.257; right ONSD-24 5.6 mm . left ONSD-24 5.5 mm, = 0.146; and ∆right ONSD 0.23 mm . ∆left ONSD 0.22, = 0.717) and between the stroke-affected side and non-stroke-affected side measurements (stroke-affected ONSD-0 5.2 mm . non-stroke-affected ONSD-0 5.2 mm, = 0.292; stroke-affected ONSD-24 5.5 mm . non-stroke-affected ONSD-24 5.4 mm, = 0.124; and ∆stroke-affected ONSD 0.23 mm . non-∆stroke-affected ONSD 0.23 mm, = 0.569). Intracranial complications occurred in 14 (15%) patients. There was no difference in ONSD values between patients with and without complications ( = 0.338 for aONSD-0, = 0.216 for aONSD-24, and = 0.902 for ∆a ONSD). There was no significant difference between the aONSD-0 and aONSD-24 values of surviving and non-surviving patients (aONSD-0: 5.3 ± 0.7 . 5.0 ± 0.5, = 0.345; aONSD-24: 5.5 ± 0.7 . 5.3 ± 0.4, = 0.522; and = 0.386 for ∆ aONSD).
ONSD values on 24-h brain CT scans were higher than admission values in acute stroke patients receiving thrombolytic therapy, irrespective of the right or left side, stroke-affected side, presence of complications, and mortality. However, ONSD is not a sufficient parameter for predicting complications and death.
中风导致的缺血性梗死会使颅内压升高。本研究旨在评估溶栓前和溶栓后视神经鞘直径（ONSD）测量值对中风患者临床结局和并发症的预测作用。
在计算机断层扫描（CT）上测量ONSD。计算左右眼的平均ONSD（aONSD）。根据左右眼、大脑中风受累侧、并发症的存在情况和死亡率，比较溶栓前（ONSD-0）和溶栓后（ONSD-24）的值。
共纳入93例患者；52.7%为女性，所有参与者的平均年龄为76岁。aONSD-24值高于aONSD-0值（分别为5.5±0.7mm和5.3±0.7mm，P<0.001）。左右测量值之间无显著差异（右眼ONSD-0为5.3mm，左眼ONSD-0为5.3mm，P=0.257；右眼ONSD-24为5.6mm，左眼ONSD-24为5.5mm，P=0.146；∆右眼ONSD为0.23mm，∆左眼ONSD为0.22mm，P=0.717），中风受累侧和非中风受累侧的测量值之间也无显著差异（中风受累侧ONSD-0为5.2mm，非中风受累侧ONSD-0为5.2mm，P=0.292；中风受累侧ONSD-24为5.5mm，非中风受累侧ONSD-24为5.4mm，P=0.124；∆中风受累侧ONSD为0.23mm，非∆中风受累侧ONSD为0.23mm，P=0.569）。14例（15%）患者发生颅内并发症。有并发症和无并发症患者的ONSD值无差异（aONSD-0的P=0.338，aONSD-24的P=0.216，∆aONSD的P=0.902）。存活和非存活患者的aONSD-0和aONSD-24值之间无显著差异（aONSD-0：5.3±0.7对5.0±0.5，P=0.345；aONSD-24：5.5±0.7对5.3±0.4，P=0.522；∆aONSD的P=0.386）。
接受溶栓治疗的急性中风患者24小时脑部CT扫描的ONSD值高于入院时的值，无论左右侧、中风受累侧、并发症的存在情况和死亡率如何。然而，ONSD不是预测并发症和死亡的充分参数。
