Evaluation of Optic Nerve Sheath Diameter by Computerized Tomography in the Detection of Early Stage Acute Ischemic Cerebrovascular Disease

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.

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.

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.

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.