Prognostic value of the optic nerve sheath thickness as an indicator of intracranial pressure among acute stroke patients

Aim: To evaluate the clinical value of optic nerve sheath thickness (ONST) in stroke patients. Method: The present study was prospectively performed on 386 stroke patients who were admitted to Emergency Department, and 75 healthy volunteers of similar age and gender groups. The following criteria were evaluated for each patient: age, gender, comorbidities, neurological deficit levels [Glasgow Coma Scale (GCS), the National Institute of Health Sciences Scale (NIHSS)], tomography findings (hemorrhagic / ischemic), ONST diameter in ultrasound scan, hospitalization and mortality rates. Results: The median ONST value was 5.5 mm (IQR: 0.30) for the hemorrhagic stroke patients, and 5.25 mm (IQR: 0.20) for the ischemic stroke patients. The median ONST value of the stroke patients was significantly higher. Also, the ONST values of the hemorrhagic stroke patients were found to be significantly higher. In our study, the area below the curve was 0.865. For the 4.5 mm cut-off value, the sensitivity was 96.1% and specificity was 82.7%. Conclusions: The results of our study showed that the ONST increased in the stroke patients and this increase was higher in the hemorrhagic stroke patients. We suggest that the treatment can be considered to decrease intracranial pressure if there is an increase in ONST in stroke patients.