The relationship between optic nerve sheath diameter and clinical outcome in acute stroke patients receiving thrombolytic treatment

İntroduction: Ischemic stroke; neurological dysfunction due to focal cerebral, spinal or retinal infarction. The most effective treatment approach in acute stroke is thrombolytic therapy. Intracranial pressure increases due to stroke and its complications. In our study, we aimed to evaluate the usefulness of optic nerve sheath diameter (ONSD) measurement in brain tomography in order to predict intracranial pressure increase secondary to stroke and its complications. Materials and Methods: The present study consisted of 93 patients who presented to the Emergency Department of Dokuz Eylul University Emergency Department between 01.01.2015-01.06.2018 and who received thrombolytic therapy. Major complaints, age and gender, co-morbid diseases, vital signs, GCS, post thrombolytic complications, arrival NIHSS, 24 hours and 7-day mortality, MRS results at arrival and 7-day were evaluated. Optic nerve sheath diameters were compared in pre-thrombolytic (ONSD-0) and post-thrombolytic (ONSD-24) brain tomography. Results: 49 of the patients were women and mean age was 76 (range: 37-94). In 86 (92.4%) patients, at least one comorbid disease was present. The most common comorbid disease was hypertension (n=65, 69.9%). The most common post-thrombolytic complication was intracranial bleeding. A significant difference was found between ONSD-0 and ONSD-24 measurements in both the right and left side of the patients (p <0.001 and p <0.001). There was a statistically significant difference between the ONSD-0 and ONSD-24 measurements on the affected side and the unaffected side (p <0.001 and p = 0.001).When ONSD-0 values are examined; There was no statistically significant difference between the groups when they were grouped as both right and left sides and affected and unaffected sides (p = 0.666 and p = 0.513). When ONSD-24 values were compared, there was no difference between right and left side or between affected and unaffected side (p = 0.470 and p = 392).When the ONSDs of 12 patients who developed complications were evaluated according to the affected side characteristics; Affected-24 ONSD measurements were significantly higher than the Affected-0 measurements (p = 0.006). There was no significant difference in the unaffected area (p = 0.201). According to the results of the patients, all patients were alive at 24 hours and in the seventh day, 5.4% (n = 5) died. Conclusion: On the 24th hour after thrombolytic therapy in patients who underwent thrombolytic therapy due to acute stroke, ONSD values were increased when evaluated both as right and left side and as affected and unaffected side. There was no difference between ONSD-0 measurements between the right and left sides and between the affected and unaffected sides. In the 24th hour control BBT measurements, there was no difference between ONSD-24 measurements between the right and left sides and between the affected and unaffected sides. There was a difference between ONSD-24 values on the affected side in patients with intracranial complications. According to these results, ONSD increases in stroke patients receiving thrombolytic therapy. Significant elevation in the ONSD of the affected region in patients with intracranial complication development suggests that ONSD measurement is a promising method for predicting the development of complications. Although ONSD measurement appears to be a non-invasive method that can be easily applied in acute stroke patients, it is not enough alone. Further studies are needed.