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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Measuring the Optic Nerve Sheath Diameter with Ultrasound in Acute Middle Cerebral Artery Stroke Patients
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Measuring the Optic Nerve Sheath Diameter with Ultrasound in Acute Middle Cerebral Artery Stroke Patients

机译：用超声测量急性中间脑动脉卒中患者的超声波神经鞘直径

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Background: Measurement of the optic nerve sheath diameter (ONSD) with ultrasound enables non-invasive and indirect assessment of increased intracranial pressure (ICP). Although most of the studies were employed with traumatic brain injury patients, its increasingly popular in acute ischemic stroke (AIS) studies. Objectives: Evaluating whether using ONSD as a follow-up measurement would help monitor the thrombolytic therapy (TT) effectiveness and determine the high-risk patients for malignant middle cerebral artery (MCA) syndrome. Methods: This prospective observational study was conducted between August 1, 2019, and February 1, 2020, in a tertiary hospital. Forty-four patients were eligible. We determined the TT moment as the time when the first ocular ultrasound measurement would be made (time 0). Also, we decided on the 24th h after the treatment as the time to perform the second ocular ultrasound measurement (time 24). The National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Alberta Stroke Program Early Computed Tomography (ASPECT) scores were evaluated blindly at the time-0 and the time-24. The cut-off value of ONSD was 0.55 mm. Results: There was no difference in ONSD results before and after the TT (p = 0.414). But, patients with an equal or higher value than cut-off had an increased risk for complications such as malignant-MCA, bleeding, seizure, etc. (p = 0.05). Malignant-MCA was observed in four patients with higher ONSD values. At the time-24, NIHSS decreased, GCS and ASPECT scores increased. Finally, ONSD was positively correlated with the NIHSS and negatively correlated with the GCS at the time-24. Conclusions: Monitoring ONSD values in both the emergency department and the intensive care unit may be useful in the early diagnosis of MCA stroke complications and the follow-up of TT's effectiveness.
机译：背景：通过超声测量视神经鞘直径（ONSD）可以无创间接评估颅内压升高（ICP）。虽然大多数研究都是针对创伤性脑损伤患者，但其在急性缺血性中风（AIS）研究中越来越流行。目的：评估使用ONSD作为随访指标是否有助于监测溶栓治疗（TT）的有效性，并确定恶性大脑中动脉（MCA）综合征的高危患者。方法：这项前瞻性观察研究于2019年8月1日至2020年2月1日在一家三级医院进行。44名患者符合条件。我们确定TT时刻为进行第一次眼部超声测量的时间（时间0）。此外，我们决定在治疗后24小时进行第二次眼部超声测量（时间24）。在时间-0和时间-24时，对国家卫生研究所中风量表（NIHSS）、格拉斯哥昏迷量表（GCS）和艾伯塔省中风项目早期计算机断层扫描（ASPECT）评分进行盲法评估。ONSD的截止值为0.55 mm。结果：TT前后ONSD结果无差异（p=0.414）。但是，与临界值相等或更高的患者发生恶性MCA、出血、癫痫等并发症的风险增加（p=0.05）。在四名ONSD值较高的患者中观察到恶性MCA。到24岁时，NIHSS下降，GCS和方面得分增加。最后，在24小时内，ONSD与NIHSS呈正相关，与GCS呈负相关。结论：在急诊科和重症监护室监测ONSD值可能有助于MCA卒中并发症的早期诊断和TT疗效的随访。

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