TITLE:
Correlation between Optic Nerve Sheath Diameter Measured by POCUS and Neurological Deficit in Physical Examination in Adult Patients with Suspected Ischemic Stroke Evaluated in Emergency Departments
AUTHORS:
Rodriguez de Molina Jose Ivan, Arechiga Glenda, Torres Esthefany, Carrillo Renato
KEYWORDS:
Optic Nerve Sheath Diameter, Ultrasound, Stroke, Neurological Focalization, Emergency Medicine
JOURNAL NAME:
Open Journal of Emergency Medicine,
Vol.13 No.4,
November
28,
2025
ABSTRACT: Background: Rapid and accurate lateralization of neurological deficits is critical in the acute management of stroke and other neuro-emergencies. Optic nerve sheath diameter (ONSD), assessed by ultrasound, is a non-invasive marker of intracranial pressure. However, its role in detecting hemispheric asymmetry and predicting the side of neurological focalization remains poorly defined. Methods: We conducted a prospective observational study including 19 adult patients presenting with acute neurological deficits to the emergency department of Clínica México. Bilateral ONSD was measured using ocular ultrasound, and asymmetry was calculated as Δ ONSD = right − left. The primary outcome was the correlation between Δ ONSD and the side of neurological focalization on physical examination. Secondary outcomes included associations with stroke severity (NIHSS), neurological improvement, and diagnostic accuracy. Data were analyzed with Wizard Pro software. This protocol was registered at ClinicalTrials.gov (NCT06492681). Results: The mean age of patients was 68.4 ± 11.1 years, with 57.9% males. The main comorbidities were hypertension (73.7%), diabetes (36.8%), and previous stroke (36.8%). A significant correlation was found between Δ ONSD and the side of focalization (p