Evaluation of Optic Nerve Diameter Measurement :According to Bleeding Subtypes in Patients with Non-Traumatic Intracranial Hemorrhage in the Emergency Department

Yıl 2022, Cilt: 8 Sayı: 2, 242 - 248, 31.05.2022

Şeyda Savrun Bilge Akhan Halil Arslan

https://doi.org/10.19127/mbsjohs.1062196

Öz

Objective: Nontraumatic intracranial hemorrhage is an important cause of adult death and disability. The optic nerve sheath is surrounded by cerebrospinal fluid. Therefore, the increase in intracranial pressure; causes a diameter change in the optic nerve sheath. In this direction, to determine the changes in optic nerve diameter measurements according to the bleeding subtypes of patients diagnosed with non-traumatic intracranial hemorrhage in the emergency department. Thus, it is aimed to assist in early diagnosis and treatment.
Methods: The study is retrospective and includes 136 patients diagnosed with non-traumatic intracranial hemorrhage, who applied to the 3rd level university hospital emergency department between January 01/ 2015 and June 01/ 2017. The parameters of each patient at the time of first admission and at eight hours were checked. These were subtypes of bleeding in brain tomography, amount of bleeding, optic nerve diameter measurements, Glasgow coma scales and demographic characteristics.
Results: 136 patients were included in the study. The mean age of the patients was 64.5 ± 17.8 years, 47.1% were female (n=64), 52.9% were male (n=72). Intracranial hemorrhage was 64.7% (n=88), subdural hemorrhage was 29.4% (n=40), and epidural hemorrhage was 5.9% (n=8) (p<0.001). In addition, the patients showed a significant increase in both the right and left optic nerve diameter at the 8th hour (p<0.001). Bleeding diameter increased in parallel with the increase in right and left optic nerve diameter. Similarly, a significant decrease was observed in Glasgow Coma Scales at the 8th hour (13.0 (2)) compared to the first admission (14.0 (1)) (p<0.001).
Conclusion: When evaluating brain tomography of patients with nontraumatic intracranial hemorrhage; In addition to the existing parameters, it is recommended to look at the optic nerve diameter change.

Anahtar Kelimeler

Non-traumatic, intracerebral hemorrhage, optic nerve diameter, glaskow coma scale

Proje Numarası

yok

Kaynakça

• 1. Gonzalez-Duarte A, Cantu C, Ruiz-Sandoval JL, Barinagarrementeria F. Recurrent Primary Cerebral Hemorrhage Frequency, Meohanisms, and Prognosis. Stroke. 1998;29:1802-1805.
• 2. Hacke W, Schwab S, Horn M, Spranger M, De Georgia M, von Kummer R. 'Malignant' middle cerebral artery territory infarction: clinical course and prognostic signs. Arch Neurol. 1996;53:309-315.
• 3. Hansen HC, Helmke K. The subarachnoid space surrounding the optic nerves. An ultrasound study of theoptic nerve sheath. Surg Radiol Anat. 1996;18 (4) :323-8.
• 4. Rickert K, Sinson G. Intracranial pressure monitoring. Oper Tech Gen Surg. 2003;5:170-175.
• 5. Vavilala MS, Lujan SB, Qiu Q, Petroni GJ, Ballarini NM, Guadagnoli N, et al. Benchmarking Prehospital and Emergency Department Care for Argentine Children with Traumatic Brain Injury: For the South American Guideline Adherence Group PLoS One. 2016;11 (12) :e0166478.
• 6. Bombacı E, Boztepe A, Cizen A, Cevik Z, Çolakoglu S, Yollu Atakan T. The relationship between bispectral index monitoring and modified Glasgow coma and Ramsay sedation scale scores in unconscious intensive care patients. Bakirköy Medical Journal. 2005;1 (3):90-4.
• 7. Hayreh SS. Pathogenesis of edema of the optic disc. Doc Ophthalmol. 1968;24:289-411
• 8. Amini A, Kariman H, Dolatabadi AA, Hatamabadi HR, Derakhshanfar H, Mansouri B, et al. Use of the sonographic diameter of optic nerve sheath to estimate intracranial pressure. Am J Emerg Med. 2013;31 (1) :236-9.
• 9. Sekhon MS, McBeth P, Zou J, Qiao L, Kolmodin L, Henderson WR, et al. Association between optic nerve sheath diameter and mortality in patients with severe traumatic brain injury. Neurocritical care. 2014;21 (2) :245-52.
• 10. Karasu A, Sabancı PA, Cansever T, Hepgül KT, Imer M, Dolaş I, et al. Epidemiological study in head injury patients. National Journal of Trauma Emergency Surgery. 2009;15 (2) :159-163.
• 11. Cokuk A, Kozaci N, Ay MO, Acikalin A, Seviner M, Satar S. Evaluation of Head Trauma Cases in the Emergency Department. Cukurova Medical Journal. 2013;38;63-71.
• 12. Thomas Geeraerts, Sybille Merceron, Dan Benhamou, Bernard Vigue, Jacques Duranteau. Non-invasive assessment of intracranial pressure using ocular sonography in neurocritical care patients. Intensive Care Med. 2008;34:2062-67.
• 13. Karakitsos D, Soldatos T, Gouliamos A, Armaganidis A, Poularas J, Kalogeromitros A, et al. Transorbital sonographic monitoring of optic nerve diameter in patients with severe brain injury. Transplant Proc. 2006;38:3700-6.:963-7.
• 14. Guzelda S, Yılmaz G, Tuna M, Altuntas M, Ozdemir M. Measuring the Optic Nerve Sheath Diameter with Ultrasound in Acute Middle Cerebral Artery Stroke Patients. Journal of Stroke and Cerebrovascular Diseases,2021,30.2: 105523.
• 15. Celik K, Demiryurek B. E.The association between intracranial pressure and optic nerve sheath diameter on patients with head trauma. Arq Neuropsiquiatr 2021;79(10):879-885
• 16. Kim D Y, Kim S Y, Hong D Y, sung B Y, Lee S, Paik J H et all. Comparison of ultrasonography and computed tomography for measuring optic nerve sheath diameter for the detection of elevated intracranial pressure. Clinical Neurology and Neurosurgery 204 (2021) 106609
• 17. Altayar A S, Abouelela A Z, Abdelshafey E E, Mohammed K S, Hassan A A, Khattab M A et all. Optic nerve sheath diameter by ultrasound is a good screening tool for high intracranial pressure in traumatic brain injury. Ir J Med Sci (2021) 190:387–393