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

Completed

Conditions

Intervention / Treatment

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

Observational

Enrollment (Actual)

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

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
Intervention / Treatment
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

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

Ankara City Hospital Bilkent

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2021

Primary Completion (Actual)

September 30, 2021

Study Completion (Actual)

December 31, 2021

Study Registration Dates

First Submitted

September 8, 2026

First Submitted That Met QC Criteria

September 8, 2026

First Posted (Actual)

September 14, 2026

Study Record Updates

Last Update Posted (Actual)

September 14, 2026

Last Update Submitted That Met QC Criteria

September 8, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID 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.

Subscribe