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Role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarction

Senol, Ozgur ; Cosgun, Zeliha ; Dagistan, Emine ; Demiryurek, Bekir Enes ; Cancan, Seckin Emre

Arquivos de neuro-psiquiatria, 2022-07, Vol.80 (7), p.671-675 [Periódico revisado por pares]

Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil: Thieme Revinter Publicações Ltda

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Título:
Role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarction
Autor: Senol, Ozgur ; Cosgun, Zeliha ; Dagistan, Emine ; Demiryurek, Bekir Enes ; Cancan, Seckin Emre
Assuntos: Adult ; Aged ; Cerebral infarction ; Child, Preschool ; Coma ; Computed tomography ; decompressive craniectomy ; Edema ; EKG ; Humans ; infarction ; Infarction, Middle Cerebral Artery - diagnostic imaging ; Infarction, Middle Cerebral Artery - surgery ; Intracranial Hypertension - diagnostic imaging ; Intracranial Hypertension - surgery ; Intracranial Pressure - physiology ; Middle Aged ; middle cerebral artery ; NEUROSCIENCES ; Neurosurgery ; Optic nerve ; Optic Nerve - diagnostic imaging ; Optic Nerve - surgery ; optic nerve neoplasms ; Original ; Original Article ; Patients ; PSYCHIATRY ; Skull ; Stroke ; Surgery ; Treatment Outcome
É parte de: Arquivos de neuro-psiquiatria, 2022-07, Vol.80 (7), p.671-675
Notas: ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
ObjectType-Article-3
Conflict of Interest
The authors have no conflict of interests to declare.
Descrição: Abstract Background After a case of stroke, intracranial pressure (ICP) must be measured and monitored, and the gold standard method for that is through an invasive technique using an intraventricular or intraparenchymal device. However, The ICP can also be assessed through a non-invasive method, comprised of the measurement of the optic nerve sheath diameter (ONSD) through ultrasound (US). Objective To evaluate the ICP of patients who underwent wide decompressive craniectomy after middle cerebral artery (MCA) infarction via preoperative and postoperative ONSD measurements. Methods A total of 17 patients, aged between 34 and 70 years, diagnosed with malignant MCA infarction with radiological edema and mid-line shift, who underwent decompressive surgery, were eligible. From the records, we collected data on age, sex, preoperative and postoperative Glasgow Coma Scale (GCS) scores, National Institutes of Health Stroke Scale (NIHSS) score, the degree of disability in the preoperative period and three months postoperatively through the scores on the Modified Rankin Scale (MRS), and the preoperative and postoperative midline shift measured by computed tomography (CT) scans of the brain. Results Preoperatively, the mean GCS score was of 8 (range: 7.7–9.2), whereas it was found to be of 12 (range 10–14) on the first postoperative day ( p = 0.001). The mean preoperative NIHSS score was of 21.36 ± 2.70 and, on the first postoperative day, it was of 5.30 ± 0.75 ( p < 0.001). As for the midline shift, the mean preoperative value was of 1.33 ± 0.75 cm, and, on the first postoperative day, 0.36 ± 0.40 cm ( p < 0.001). And, regarding the ONSD, the mean preoperative measurement was of 5.5 ± 0.1 mm, and, on the first postoperative day, it was of 5 ± 0.9 mm ( p < 0.001). Conclusion The ocular US measurement of the ONSD for the preoperative and postoperative monitoring of the ICP seems to be a practical and useful method.
Editor: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil: Thieme Revinter Publicações Ltda
Idioma: Inglês;Português

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Role of the optic nerve sheath diameter in the assessment of the effectiveness of decompressive surgery after malignant middle cerebral artery infarction

Senol, Ozgur ; Cosgun, Zeliha ; Dagistan, Emine ; Demiryurek, Bekir Enes ; Cancan, Seckin Emre

Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil: Thieme Revinter Publicações Ltda

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