Value of Optic Nerve Sheath Diameter in Differentiating Ischemic From Hemorrhagic Stroke

September 8, 2026 updated by: Cagdas Yildirim, MD, Ankara City Hospital Bilkent

Diagnostic Value of Bedside Ultrasonographic Optic Nerve Sheath Diameter Measurement in Differentiating Ischemic From Hemorrhagic Stroke in the Emergency Department

We aimed to examine bedside ONSD values measured by ocular ultrasonography in patients presenting to the ED with stroke, and to determine a diagnostic cut-off value for differentiating ischemic from hemorrhagic stroke.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This study was conducted prospectively and observationally in the adult emergency department of a tertiary training and research hospital. Patients older than 18 years who presented to the ED with stroke on the investigator's shift days, who were not followed up or treated by the investigator, and who were diagnosed with cerebrovascular disease (CVD) by radiological imaging (CT/MRI) were included in the study. Patients who were intubated, those who were unwilling to participate, and those in whom mass, aneurysm, metastasis, hydrocephalus, sarcoidosis, ventriculoperitoneal shunt, optic neuritis, or any cause that could lead to cerebral edema or affect the ONSD by raising ICP was identified in their history or on imaging were excluded.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
64

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Ankara, Turkey (Türkiye)
        • Ankara Bilkent City Hospital Emergency Medicine Department

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population consists of adult patients (aged 18 years and older) who presented to the adult emergency department of a tertiary training and research hospital with symptoms of acute stroke. To be included in this population, patients must have a confirmed diagnosis of cerebrovascular disease (either ischemic or hemorrhagic stroke) verified by radiological neuroimaging (CT or MRI). The population strictly excludes intubated patients and individuals with a history or imaging evidence of pre-existing conditions that could independently raise intracranial pressure or cause cerebral edema, such as intracranial masses, aneurysms, metastases, hydrocephalus, or optic neuritis.

Description

Inclusion Criteria:

  • Patients older than 18 years presenting to the ED with stroke.
  • Patients diagnosed with cerebrovascular disease (CVD) by radiological imaging (CT/MRI).

Exclusion Criteria:

  • Patients who are intubated. Patients unwilling to participate.
  • History or imaging findings of mass, aneurysm, metastasis, hydrocephalus, sarcoidosis, ventriculoperitoneal shunt, or optic neuritis.
  • Any condition leading to cerebral edema or affecting ONSD by independently raising intracranial pressure.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Group 1
Hemorrhagic Stroke Patients
Diagnostic test: Bedside Ocular Ultrasonography (ONSD Measurement)
Measurement of the optic nerve sheath diameter using a high-frequency (4-10 MHz) linear probe at 3 mm posterior to the papilla, immediately after the CT/MRI procedure.
Group 2
Ischemic Stroke Patients
Diagnostic test: Bedside Ocular Ultrasonography (ONSD Measurement)
Measurement of the optic nerve sheath diameter using a high-frequency (4-10 MHz) linear probe at 3 mm posterior to the papilla, immediately after the CT/MRI procedure.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Cut-off Value of Optic Nerve Sheath Diameter (ONSD)
Time Frame: Evaluated immediately following the initial imaging procedure (CT/MRI) in the emergency department.
Determination of the optimal ONSD cut-off value (in millimeters) to effectively differentiate between ischemic and hemorrhagic stroke subtypes.
Evaluated immediately following the initial imaging procedure (CT/MRI) in the emergency department.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ankara City Hospital Bilkent

Publications and helpful links

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General Publications

Study record dates

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Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
April 1, 2021

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 30, 2021

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2021

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
September 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 8, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
September 14, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 14, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 8, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • ASH3

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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