Optic nerve diameter measurement with ultrasound in patients admitting to the emergency department with headache

OBJECTIVE: Patients over the age of 18 who presented to the emergency department with headache were included in our study. It was aimed to determine whether there is any similarity between the patients presenting with headache by examining them with ultrasound, which is a non-invasive method that can be performed at the bedside, and comparing the CT findings with bilateral optic nerve diameter measurements. MATERIAL AND METHOD: This study was conducted in the Emergency Medicine Clinic of Gaziantep University Faculty of Medicine conscious, cooperative and oriented adult patients over the age of 18 who were admitted to the emergency department with headache were included in the study. Optic nerve diameters of both eyes were measured using a linear probe with a frequency range of 6.0- 13.0 MHz. Both eyes were covered and gel was applied on the eyelid; Then, first longitudinal and short axis sweep images were taken with the linear probe. Optic nerve measurement was taken 3 mm behind the optic disc. Measurements greater than 5 mm in diameter were considered pathological. The study was completed within 1 (one) year. The study is the number determined statistically after the power analysis; It was performed with 64 patients with headache and 64 patients without headache. The study data were evaluated statistically using the SPSS 22.0 Windows version package program. RESULTS: As a result of the evaluation of bilateral optic nerve diameter measurement in 64 patients with headache and 64 without headache over the age of 18 who participated in the study; Optic nerve diameter measurement values are not dependent on gender, optic nerve diameter measurement values are higher in the group with headache and the group without headache in the same age group, on the side with intracranial pathologies, on the side with cataract, on the side of the previous SVO sequela lesion, posttraumatic external hematoma. It was found that the nerve diameter measurement value was increased compared to the healthy side. Incidental retinal detachment was detected in a 35-year-old patient who was admitted to the study with headache and had no comorbid disease. DISCUSSION AND CONCLUSION: Headache is one of the most common complaints at the emergency service. Since the underlying pathology can be in a wide range, it is very important to be able to make a fast and accurate diagnosis in order to prevent some life-threatening situations. Ultrasound has been used frequently in the emergency department in recent years due to its ability to be performed at the bedside, non-invasive and low cost. In our study, the results of optic nerve diameter measurement in the same direction with CT may indicate that the first evaluation of the patients can be made with ultrasound. It is obvious that many more studies are needed in order to standardize the measurement of optic nerve diameter with ultrasound. KEYWORDS:Emergency Department, Headache, Optic Nerve, Ultrasound, Ocular Ultrasonography, Intracranial Pressure