Dergiler / Ulusal Travma ve Acil Cerrahi Dergisi / 2018 / Cilt: 24 - Sayı: 4

Multislice computed tomographic measurements of optic nerve sheath diameter in brain injury patients

Beyin hasarı olan hastalarda çok kesitli bilgisayarlı tomografide optik sinir kılıfı ölçümleri

Sayfa
316–320
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Severe structural changes in the brain and trauma that causes bleeding have only limited effects on the extension of the optic nerve.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:BACKGROUND: Currently, the measurement of optic nerve sheath diameter (ONSD) has been offered as a possible indicator of intracranial pressure (ICP).
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Temel Bulgular & Veri:Increased ICP is observed during intracranial injury.
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Sonuç & Katkı:Severe structural changes in the brain and trauma that causes bleeding have only limited effects on the extension of the optic nerve.
🔬Tür:Literatür & Derleme Çalışması
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

BACKGROUND: Currently, the measurement of optic nerve sheath diameter (ONSD) has been offered as a possible indicator of intracranial pressure (ICP). Increased ICP is observed during intracranial injury. The objective of this study was to evaluate the relationship between increased ONSD and positive intracranial findings from multislice computed tomography (CT) of the brain. METHODS: In total, CT scans of 161 patients were retrospectively reviewed. The image that showed the largest ONSD was magnified five times. RESULTS: The CT scan revealed intracranial lesions in 54 patients and no intracranial lesions in 107 patients. A significant relationship was observed between positive CT findings and increased ONSD: 5.60±0.75 mm vs. 5.35±0.75 mm (p=0.038). The area under the receiver operating characteristic curve was 0.600 (95% confidence interval, 0.508–0.692; p<0.039). A cut-off value of ≥5.0 mm had a sensitivity and specificity of 80% and 36%, respectively. CONCLUSION: This study demonstrated a significant yet poor relationship between intracranial injury and increased ONSD from the multislice CT scan. Severe structural changes in the brain and trauma that causes bleeding have only limited effects on the extension of the optic nerve.

Abstract

AMAÇ: Günümüzde, kafa içi basıncın (KİB) belirlenmesinde, optik sinir kılıfı çapı (OSKÇ) ölçümlerinden faydalanılabileceği belirtilmektedir. KİB artışı, intrakraniyal yaralanmaların doğal bir sonucudur. Bu çalışmada, çok kesitli bilgisayarlı beyin tomografisindeki, pozitif intrakraniyal bulgular ve OSKÇ genişlemesi arasındaki ilişki değerlendirildi. GEREÇ VE YÖNTEM: Toplam 161 hastanın çok kesitli BT görüntüleri geriye dönük incelendi. Ölçümler, kesitlerde optik sinirin en geniş görüldüğü bölge beş kez büyütülerek yapıldı. BULGULAR: Çok kesitli beyin tomografisi görüntülerinde, 54 hastada kafa içi hasar tespit edilirken, 107 hastada edilmedi. Pozitif tomografi bulguları ile OSKÇ artışı arasında anlamlı ilişki olduğu belirlendi, 5.60±0.75 mm ve 5.35±0.75 mm (p=0.038). ROC eğrisinin altında kalan alan, 0.600 (%95 güven aralığında 0.508–0.692; p<0.039). OSKÇ eşik değeri ≥5 mm, duyarlılık %80, özgüllük %36 olarak belirlendi. TARTIŞMA: Bu çalışma, çok kesitli tomografilerde incelenen kafa içi hasar ile OSKÇ artışı arasında anlamlı ancak zayıf bir ilişki olduğunu gösterdi. Beyinde ciddi yapısal değişikliklere ve kanamaya yol açacak travmalar, optik sinirin genişlemesi üzerinde ancak sınırlı bir etkiye sahiptir.

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Bu Makaleye Atıf Yap

ÖZSARAÇ, M., DÜZGÜN, F., GÖLCÜK, Y., PABUŞÇU, Y., BİLGE, A., İRİK, M., YILMAZ, H. (2018). Multislice computed tomographic measurements of optic nerve sheath diameter in brain injury patients. Ulusal Travma ve Acil Cerrahi Dergisi, Cilt: 24 - Sayı: 4, 316–320. https://ajindex.com/articles/324796

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