Introduction

We aimed to predict intracranial pressure(ICP)after cerebral ischemic stroke by measuring diameter of the optic nerve sheath(ONSD)with bedside ultrasonography(US). In order to see the ICP changes,it was planned to record delta ICP changes at the 3rd and 5th day follow-up of the patients

Methots

Patients aged 18 years or older who were admitted to the emergency department(ED)with stroke symptoms for one year were included.Demographic data,time elapsed since the onset of symptoms,neurogical status assesment scales,ONSD values measured by US in three time periods(the day the patient was admitted to the ED,the 3rd and 5th days of hospitalization),MDCT findings when the patient was admitted,ONSD values in MDCT,whether they received tissue plasminogen activator(tPA)and whether they underwent decompression surgery were recorded.

Results

The average age of the 82 patients was 67.5(range 33–89)years.Forty-two patients(51.2%)were male.On both the right and left sides,ONSD on the 3rd day was larger(>5 mm)than on first day(p < 0.05). ONSD on the 5th day was larger than on the first day(p > 0.05). All ONSD results measured using both US and MDCT showed a positive correlation between the same eye and contralateral eye measurements(p < 0.05).

Discussion

CT is the most critical radiological method for stroke patients.Transport to radyology unit in unstable patients carries risk and is not recommended.Optic nerve US can be used in the early diagnosis of ICP increase and provides early treatment.The ease of use and safety in unstable patients have increased its popularity.

Conclusion

We believe that measuring ONSD using US is an appropriate choice on ICP management in stroke patients.

中文翻译：

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缺血性脑卒中后床旁超声检查视神经鞘径测量颅内压的评价

介绍

我们旨在通过床边超声（US）测量视神经鞘（ONSD）的直径来预测脑缺血性卒中后的颅内压（ICP）。为了观察 ICP 变化，计划在患者随访的第 3 天和第 5 天记录 delta ICP 变化

方法

纳入 18 岁或以上因中风症状入院急诊科（ED）一年的患者。人口统计数据、症状出现后的时间、神经状态评估量表、美国在三个时间段测量的 ONSD 值记录患者入院当天、入院第3天、第5天）、入院时MDCT表现、MDCT中ONSD值、是否接受组织型纤溶酶原激活剂（tPA）、是否接受减压手术.

结果

82 例患者平均年龄 67.5（范围 33-89）岁。42 例患者（51.2%）为男性。在右侧和左侧，第 3 天的 ONSD 大于（>5 mm）第一天（p < 0.05）。第5天ONSD大于第1天(p > 0.05)。使用 US 和 MDCT 测量的所有 ONSD 结果显示，同一只眼睛和对侧眼睛测量值之间呈正相关（p < 0.05）。

讨论

CT 是脑卒中患者最关键的放射学方法。不稳定患者转运至放射科有风险，不推荐。视神经超声可用于早期诊断 ICP 增加并提供早期治疗。使用方便且安全不稳定的患者增加了它的受欢迎程度。

结论

我们认为使用超声测量 ONSD 是脑卒中患者 ICP 管理的合适选择。