Optic Nerve Diameter and Elevation in Acute Large Stroke Patients

Abstract Background Elevated intracranial pressure (ICP) is a potentially devastating condition resulting from various neurological and non-neurological disorders. Aim of the Work To assess the correlation between optic nerve diameter, optic disc elevation and increased intracranial tension due to intracranial heamorrhage or large stroke and to compare it with control group. Patients and Methods This study was conducted on 51 patients diagnosed with acute large stroke, admitted in stroke unit neurology department at Ain Shams university hospitals and 56 Controls diagnosed with lacunar stroke or healthy individuals age and sex matched. Results A significant positive correlation between Peak systolic velocity and both optic disc elevation and optic nerve sheath diameter. There was also significant positive correlation between Pulsatility index and optic nerve sheath diameter while there was no significant correlation between the Pulsatility index and optic disc elevation. A significant positive correlation between NIH stroke scale and both optic disc elevation and optic nerve sheath diameter. There was also significant positive correlation between Size of infarction and both optic nerve sheath diameter and optic nerve sheath diameter. Conclusion Increase in ONSD measurement was associated with increased hospital mortality and poor functional outcomes at 6 months. ONSD measurements may be performed using just one eye and one probe orientation to make the serial examinations easier to adopt and perform. ONSD may be used to screen stroke patients at risk of poor prognosis, especially when used in conjunction with abnormal clinical examination and CT imaging.