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J Korean Soc Emerg Med > Volume 27(5); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(5): 473-481.
혈전용해제 사용에 의한 뇌출혈 예측 인자로서 시신경초 직경의 유용성
전광훈, 김양원, 윤유상, 김태훈, 박득현
인제대학교 의과대학 응급의학교실
The Utility of the Optic Nerve Sheath Diameter in Predicting Post-Thrombolysis Intracranial Hemorrhage
Gwang Hoon Jeon, Yang Weon Kim, Yoo Sang Yoon, Tae Hoon Kim, Deuk Hyun Park
Department of Emergency Medicine, Inje University College of Medicine, Pusan, Korea
Correspondence  Deuk Hyun Park ,Tel: 051-890-6120, Fax: 051-891-1465, Email: gt-devil@hanmail.net,
Received: June 27, 2016; Revised: June 27, 2016   Accepted: August 10, 2016.  Published online: October 30, 2016.
We tried to identify the factors associated with intracranial hemorrhage (ICH) in patients with acute brain infarction receiving a tissue plasminogen activator. We assumed that ICH is increased if intracranial pressure has been increased in brain infarction patients who underwent IV thrombolysis. In this study, we selected the optic nerve sheath diameter (ONSD) in a way that intracranial pressure (ICP) measurement. ONSD measurements were compared with the occurrence of brain hemorrhage.
This study was a retrospective analysis of data acquired between January 2013 and December 2015. We included 100 acute brain infarction patients who received brain MRI and underwent IV thrombolysis in the emergency department. The ONSD measurements were taken with MRI in the axial view and compared with the occurrence of brain hemorrhage. The factors contributing to ICH in patients with thrombolysis was analyzed by a binary logistic regression analysis. Receiver operating characteristic (ROC) curves were used to find the cut-off value of ONSD that maximized the sum of the sensitivity and specificity. Statistical analysis was performed using SPSS 20.0.
The mean ONSD for patients without ICH was 5.50±0.57 mm, and for those with ICH was 5.97±0.54 mm. ONSD in the ICH group were significantly larger than in the non-ICH group (5.50±0.57 versus 5.97±0.54).
ONSD in acute brain infarction patients who underwent IV thrombolysis is useful in the assessment of ICH risk.
Key words: Brain infarction, Intracranial hemorrhage, Intracranial pressure, Optic nerve, Tissue plasminogen activator
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