ArticleFrontiers in neurology2025
Ultrasonographic assessment of optic nerve sheath diameter on the affected and unaffected sides as a predictor of clinical deterioration at discharge in patients with large hemispheric infarction.
Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and objectives: Progressive cerebral edema worsens prognosis in large hemispheric infarction (LHI). Ultrasonographic optic nerve sheath diameter (ONSD) measurement provides a non-invasive method for estimating intracranial pressure. This study aimed to evaluate the predictive value of affected- and unaffected-side ONSD for clinical deterioration at discharge in LHI patients and to provide reference data on factors linked to deterioration, follow-up outcomes, and longitudinal ONSD monitoring. Methods: This retrospective study enrolled 35 LHI patients, classified into two groups: improved and deteriorated, based on clinical and imaging findings at discharge. Demographic and clinical characteristics were compared. Receiver operating characteristic (ROC) analysis evaluated the predictive performance of affected- and unaffected-side ONSD. Area under the curve (AUC) difference was compared using the DeLong test. Post-discharge follow-up at 30 and 90 days was conducted via telephone interviews. Longitudinal changes in affected- and unaffected-side ONSD were depicted using line graphs for patients with extended stays in the neuro-intensive care unit (NICU). Results: Statistically significant variables included age ( Conclusion: Preoperative ONSD measurement is a feasible and practical predictor of discharge prognosis in LHI patients, with both affected and unaffected sides providing reliable monitoring. Factors including age, female, history of atrial fibrillation, GCS score, ONSD on either side, and NICU stay duration may influence outcomes. The high short-term mortality underscores the importance of the post-discharge transition management. The clinical value of longitudinal ONSD monitoring requires further investigation.
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