Evaluation of Optic Nerve Diameter Measurement :According to Bleeding Subtypes in Patients with Non-Traumatic Intracranial Hemorrhage in the Emergency Department

Abstract

Objective: Nontraumatic intracranial hemorrhage is an important cause of adult death and disability. The optic nerve sheath is surrounded by cerebrospinal fluid. Therefore, the increase in intracranial pressure; causes a diameter change in the optic nerve sheath. In this direction, to determine the changes in optic nerve diameter measurements according to the bleeding subtypes of patients diagnosed with non-traumatic intracranial hemorrhage in the emergency department. Thus, it is aimed to assist in early diagnosis and treatment.Methods: The study is retrospective and includes 136 patients diagnosed with non-traumatic intracranial hemorrhage, who applied to the 3rd level university hospital emergency department between January 01/ 2015 and June 01/ 2017. The parameters of each patient at the time of first admission and at eight hours were checked. These were subtypes of bleeding in brain tomography, amount of bleeding, optic nerve diameter measurements, Glasgow coma scales and demographic characteristics.Results: 136 patients were included in the study. The mean age of the patients was 64.5 ± 17.8 years, 47.1% were female (n=64), 52.9% were male (n=72). Intracranial hemorrhage was 64.7% (n=88), subdural hemorrhage was 29.4% (n=40), and epidural hemorrhage was 5.9% (n=8) (p<0.001). In addition, the patients showed a significant increase in both the right and left optic nerve diameter at the 8th hour (p<0.001). Bleeding diameter increased in parallel with the increase in right and left optic nerve diameter. Similarly, a significant decrease was observed in Glasgow Coma Scales at the 8th hour (13.0 (2)) compared to the first admission (14.0 (1)) (p<0.001).Conclusion: When evaluating brain tomography of patients with nontraumatic intracranial hemorrhage; In addition to the existing parameters, it is recommended to look at the optic nerve diameter change.