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 admittedto Emergency Department, and 75 healthy volunteers of similar age and gender groups. The followingcriteria were evaluated for each patient: age, gender, comorbidities, neurological deficit levels[Glasgow Coma Scale (GCS), the National Institute of Health Sciences Scale (NIHSS)], tomographyfindings (hemorrhagic / ischemic), ONST diameter in ultrasound scan, hospitalization and mortalityrates.Results: The median ONST value was 5.5 mm (IQR: 0.30) for the hemorrhagic stroke patients, and5.25 mm (IQR: 0.20) for the ischemic stroke patients. The median ONST value of the stroke patientswas significantly higher. Also, the ONST values of the hemorrhagic stroke patients were found to besignificantly 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 thisincrease was higher in the hemorrhagic stroke patients. We suggest that the treatment can beconsidered to decrease intracranial pressure if there is an increase in ONST in stroke patients.