Role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarction
Background After a case of stroke, intracranial pressure (ICP) must be measured and monitored, and the gold standard method for that is through an invasive technique using an intraventricular or intraparenchymal device. However, The ICP can also be assessed through a non-invasive method, comprised o...
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| Format: | Article |
| Language: | English |
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Academia Brasileira de Neurologia (ABNEURO)
2022-07-01
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| Series: | Arquivos de Neuro-Psiquiatria |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1754345 |
| _version_ | 1817984585328230400 |
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| author | Ozgur Senol Zeliha Cosgun Emine Dagistan Bekir Enes Demiryurek Seckin Emre Cancan |
| author_facet | Ozgur Senol Zeliha Cosgun Emine Dagistan Bekir Enes Demiryurek Seckin Emre Cancan |
| author_sort | Ozgur Senol |
| collection | DOAJ |
| description | Background After a case of stroke, intracranial pressure (ICP) must be measured and monitored, and the gold standard method for that is through an invasive technique using an intraventricular or intraparenchymal device. However, The ICP can also be assessed through a non-invasive method, comprised of the measurement of the optic nerve sheath diameter (ONSD) through ultrasound (US).
Objective To evaluate the ICP of patients who underwent wide decompressive craniectomy after middle cerebral artery (MCA) infarction via preoperative and postoperative ONSD measurements.
Methods A total of 17 patients, aged between 34 and 70 years, diagnosed with malignant MCA infarction with radiological edema and mid-line shift, who underwent decompressive surgery, were eligible. From the records, we collected data on age, sex, preoperative and postoperative Glasgow Coma Scale (GCS) scores, National Institutes of Health Stroke Scale (NIHSS) score, the degree of disability in the preoperative period and three months postoperatively through the scores on the Modified Rankin Scale (MRS), and the preoperative and postoperative midline shift measured by computed tomography (CT) scans of the brain.
Results Preoperatively, the mean GCS score was of 8 (range: 7.7–9.2), whereas it was found to be of 12 (range 10–14) on the first postoperative day (p = 0.001). The mean preoperative NIHSS score was of 21.36 ± 2.70 and, on the first postoperative day, it was of 5.30 ± 0.75 (p < 0.001). As for the midline shift, the mean preoperative value was of 1.33 ± 0.75 cm, and, on the first postoperative day, 0.36 ± 0.40 cm (p < 0.001). And, regarding the ONSD, the mean preoperative measurement was of 5.5 ± 0.1 mm, and, on the first postoperative day, it was of 5 ± 0.9 mm (p < 0.001).
Conclusion The ocular US measurement of the ONSD for the preoperative and postoperative monitoring of the ICP seems to be a practical and useful method. |
| first_indexed | 2024-04-13T23:46:39Z |
| format | Article |
| id | doaj.art-d99506984c3d49248acb9cdbbb34460e |
| institution | Directory Open Access Journal |
| issn | 0004-282X 1678-4227 |
| language | English |
| last_indexed | 2024-04-13T23:46:39Z |
| publishDate | 2022-07-01 |
| publisher | Academia Brasileira de Neurologia (ABNEURO) |
| record_format | Article |
| series | Arquivos de Neuro-Psiquiatria |
| spelling | doaj.art-d99506984c3d49248acb9cdbbb34460e2022-12-22T02:24:18ZengAcademia Brasileira de Neurologia (ABNEURO)Arquivos de Neuro-Psiquiatria0004-282X1678-42272022-07-01800767167510.1055/s-0042-1754345Role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarctionOzgur Senol0Zeliha Cosgun1Emine Dagistan2Bekir Enes Demiryurek3Seckin Emre Cancan4Bolu Abant Izzet Baysal University, Faculty of Medicine, Department of Neurosurgery, Bolu, Turkey.Bolu Abant Izzet Baysal University, Faculty of Medicine, Department of Radiology, Bolu, Turkey.Bolu Abant Izzet Baysal University, Faculty of Medicine, Department of Radiology, Bolu, Turkey.Bolu Abant Izzet Baysal University, Faculty of Medicine, Department of Neurology, Bolu, Turkey.Bolu Abant Izzet Baysal University, Faculty of Medicine, Department of Neurosurgery, Bolu, Turkey.Background After a case of stroke, intracranial pressure (ICP) must be measured and monitored, and the gold standard method for that is through an invasive technique using an intraventricular or intraparenchymal device. However, The ICP can also be assessed through a non-invasive method, comprised of the measurement of the optic nerve sheath diameter (ONSD) through ultrasound (US). Objective To evaluate the ICP of patients who underwent wide decompressive craniectomy after middle cerebral artery (MCA) infarction via preoperative and postoperative ONSD measurements. Methods A total of 17 patients, aged between 34 and 70 years, diagnosed with malignant MCA infarction with radiological edema and mid-line shift, who underwent decompressive surgery, were eligible. From the records, we collected data on age, sex, preoperative and postoperative Glasgow Coma Scale (GCS) scores, National Institutes of Health Stroke Scale (NIHSS) score, the degree of disability in the preoperative period and three months postoperatively through the scores on the Modified Rankin Scale (MRS), and the preoperative and postoperative midline shift measured by computed tomography (CT) scans of the brain. Results Preoperatively, the mean GCS score was of 8 (range: 7.7–9.2), whereas it was found to be of 12 (range 10–14) on the first postoperative day (p = 0.001). The mean preoperative NIHSS score was of 21.36 ± 2.70 and, on the first postoperative day, it was of 5.30 ± 0.75 (p < 0.001). As for the midline shift, the mean preoperative value was of 1.33 ± 0.75 cm, and, on the first postoperative day, 0.36 ± 0.40 cm (p < 0.001). And, regarding the ONSD, the mean preoperative measurement was of 5.5 ± 0.1 mm, and, on the first postoperative day, it was of 5 ± 0.9 mm (p < 0.001). Conclusion The ocular US measurement of the ONSD for the preoperative and postoperative monitoring of the ICP seems to be a practical and useful method.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1754345middle cerebral arteryinfarctiondecompressive craniectomyoptic nerve neoplasms |
| spellingShingle | Ozgur Senol Zeliha Cosgun Emine Dagistan Bekir Enes Demiryurek Seckin Emre Cancan Role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarction Arquivos de Neuro-Psiquiatria middle cerebral artery infarction decompressive craniectomy optic nerve neoplasms |
| title | Role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarction |
| title_full | Role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarction |
| title_fullStr | Role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarction |
| title_full_unstemmed | Role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarction |
| title_short | Role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarction |
| title_sort | role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarction |
| topic | middle cerebral artery infarction decompressive craniectomy optic nerve neoplasms |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1754345 |
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