The effectiveness of optic nerve sheath diameter in predicting large vessel occlusion in ischemic stroke patients

This study assessed the effectiveness of ultrasonography-measured optic nerve sheath diameter (ONSD) in predicting large vessel occlusion (LVO) in ischemic stroke patients.

This single-center, prospective observational study involved patients presenting to the emergency department within 24 hours of symptom onset with moderate to severe stroke, and healthy volunteers.

The study included 133 ischemic stroke patients and 63 healthy volunteers. The patient group had significantly higher right [5.8 (0.9)] and left [5.9 (0.8)] ONSD values compared to controls (right [5.7 (0.6)], left [5.7 (0.8)], p<0.001 for both). LVO was present in 58.6% (n = 78) of patients. Median right ONSD was 6.1 mm (0.8) in LVO patients vs. 5.7 mm (0.65) in non-LVO patients (p=0.002). Median left ONSD was 5.9 mm (0.9) in LVO patients vs. 5.7 mm (0.7) in non-LVO patients (p=0.002). A right ONSD ≥6 mm had 51.28% sensitivity and 78.18% specificity for LVO. A left ONSD ≥5.5 mm had 83.33% sensitivity and 40% specificity for LVO.

Elevated ONSD values measured by ultrasonography can effectively indicate LVO in stroke patients.