Abstract (english) | Optic nerve sheath diameter (ONSD) enlargement is detectable in traumatic brain injury patients with raised intracranial pressure (ICP). The aim was to assess its value in neurological patients suspected to have increased ICP. Patient clinical imaging data and hospitalization outcome were analyzed. Patients were divided into groups according to brain pathology and level of consciousness with Glasgow Coma Score (GCS). Poor hospitalization outcome was assessed by modified Rankin scale (mRS) >3. Data obtained by ocular sonography performed in acute setting were compared with data of 100 control subjects. Data were expressed as mean ± SD. Intergroup comparison was performed by Student’s t-test. Data of 34 patients (63+16 years) were suitable for analysis, including 8 primary intracerebral hemorrhage (PICH), 8 subarachnoid hemorrhage (SAH), 12 PICH or SAH and intraventricular hemorrhage (IVH), 4 tumors and 2 ischemic strokes. The mean ONSD was 5.86+0.69 mm in patients versus 4.38+0.41 mm in controls (p<0.01). ONSD was 6.28+0.61 mm in patients with GCS <8 and 5.77+0.55 mm in other patients (p<0.05). ONSD was 5.72+0.59 mm in
PICH versus 6.20+0.65 mm in PICH/SAH with IVH (p=0.1). ONSD was 5.73+0.38 mm in SAH in comparison to PICH/SAH with IVH (p=0.05). There was no statistically significant difference in optic nerve diameter between patients and controls (2.48+0.28 mm vs. 2.39+0.33 mm; p>0.05). Pronounced enlargement of ONSD was observed in patients with ICH or SAH with IVH, and in patients with GCS <8. Enlarged ONSD was associated with poor neurological outcome (mRS >3). |
Abstract (croatian) | Povećanje promjera ovojnice optičkog živca (POOŽ) vidljivo je u bolesnika s traumatskom ozljedom mozga s povećanim intrakranijskim tlakom. Cilj je bio procijeniti njegovu vrijednost u neuroloških bolesnika sa sumnjom na porast intrakranijskog tlaka. Analizirani su klinički podaci, nalazi slikovnog prikaza i ishod hospitalizacije. Bolesnici su podijeljeni u skupine prema moždanoj patologiji i razini svijesti prema rezultatu na Glasgow Coma Score (GCS). Nepovoljan ishod procijenjen je modificiranom Rankinovom skalom (mRS) >3. Podaci okularne sonografije u akutnim uvjetima uspoređeni su s podacima 100 zdravih kontrolnih osoba. Vrijednosti su prikazane kao srednje vrijednosti i standardne devijacije. Usporedba između skupina provedena je Studentovim t-testom. Za analizu su bili prikladni podaci 34 bolesnika (63+16 godina): 8 primarnih intracerebralnih krvarenja (PICK), 8 subarahnoidnih krvarenja (SAK), 12 PICK ili SAK s intraventrikulskim krvarenjem (IVK), 4 tumora i 2 ishemijska moždana udara. U bolesnika je prosječni POOŽ bio 5,86+0,69 mm u usporedbi s 4,38+0,41 mm u kontrolnih osoba (p<0,01). U bolesnika s GSK <8 POOŽ je bio 6,28+0,61 mm, kod ostalih bolesnika 5,77+0,55 mm (p<0,05). POOŽ u PICK je bio 5,72+0,59 mm, a kod PICK/SAK s IVK 6,20+0,65 mm (p=0,1). POOŽ u SAK je bio 5,73+0,38 mm u usporedbi s PICK/SAK s IVK (p=0,05). Nije bilo statistički značajne razlike u POŽ između bolesnika i kontrolnih osoba (2,48+0.28 mm odnosno 2,39+0,33 mm; p>0,05). Izrazito je povećanje POOŽ zabilježeno u bolesnika s ICK ili SAK s IVK te u bolesnika s GSK <8.Povećani POOŽ bio je povezan s lošim neurološkim ishodom (mRS >3). |