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Updated: Jun 1, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Evaluation of optic nerve sheath diameter in acute stroke: pre- and post-thrombolytic assessment
Erdem Sivas1, Nese Colak2, Basak Bayram3
1Department of Emergency Medicine, Mardin Public Hospital, Mardin, Turkey.
Background:
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.
Methods:
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 vs left eye, stroke-affected side of the brain, presence of complications, and mortality.
Results:
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, p < 0.001). There was no significant difference between right and left measurements (right ONSD-0 5.3 mm vs. left ONSD-0 5.3 mm, p = 0.257; right ONSD-24 5.6 mm vs. left ONSD-24 5.5 mm, p = 0.146; and ∆right ONSD 0.23 mm vs. ∆left ONSD 0.22, p = 0.717) and between the stroke-affected side and non-stroke-affected side measurements (stroke-affected ONSD-0 5.2 mm vs. non-stroke-affected ONSD-0 5.2 mm, p = 0.292; stroke-affected ONSD-24 5.5 mm vs. non-stroke-affected ONSD-24 5.4 mm, p = 0.124; and ∆stroke-affected ONSD 0.23 mm vs. non-∆stroke-affected ONSD 0.23 mm, p = 0.569). Intracranial complications occurred in 14 (15%) patients. There was no difference in ONSD values between patients with and without complications (p = 0.338 for aONSD-0, p = 0.216 for aONSD-24, and p = 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 vs. 5.0 ± 0.5, p = 0.345; aONSD-24: 5.5 ± 0.7 vs. 5.3 ± 0.4, p = 0.522; and p = 0.386 for ∆ aONSD).
Conclusions:
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.
