CAN BRAIN EDEMA BE PREDICTED WITH OPTIC NERVE SHEATH DIAMETER MEASUREMENT IN CASES WITH DIABETIC KETOACIDOSIS?: A PRELIMINARY STUDY
Objective: The clinical signs and symptoms of brain edema resulting from diabetic ketoacidosis (DKA) may not always be ob vious. When the intracranial pressure increases, the optic nerve sheath diameter (ONSD) simultaneously increases and can be imaged with ultrasonography. We aimed to discuss the d...
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Istanbul University Press
2022-03-01
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| Series: | İstanbul Tıp Fakültesi Dergisi |
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| Online Access: | https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/4EC4987C153A4308BC3B76CB4894198E |
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| author | Özlem Tolu Kendir Hayri Levent Yılmaz Nilgün Erkek Sinem Sarı Gökay Rıza Dinçer Yıldızdaş Bilgin Yüksel |
| author_facet | Özlem Tolu Kendir Hayri Levent Yılmaz Nilgün Erkek Sinem Sarı Gökay Rıza Dinçer Yıldızdaş Bilgin Yüksel |
| author_sort | Özlem Tolu Kendir |
| collection | DOAJ |
| description | Objective: The clinical signs and symptoms of brain edema resulting from diabetic ketoacidosis (DKA) may not always be ob vious. When the intracranial pressure increases, the optic nerve sheath diameter (ONSD) simultaneously increases and can be imaged with ultrasonography. We aimed to discuss the determinative features of ONSD measurements in brain edema (BE) in DKA. Materials and Methods: Patients who were classified as having mild, moderate and severe DKA were included in the study. Transorbital ultrasonography was performed during the first two hours of treatment while the patients remained in the supine neutral position with their eyes closed. The optic nerve sheath diameters, which appeared as a hypoechoic double-edged line 3 mm deep to the globe, were measured. The same measurements were repeated in outpatient clinic controls. The ONSD values and metabolic, neurological conditions of the patients were compared. Results: Eight patients with a mean age of 8.8±3 (Standard Deviation (SD)) years were included in the study. Seven of them presented with moderate to severe DKA. Two patients suffering from headaches were found to have mild BE according to the brain computerized tomography (CT). The ONSD was 5.7±0.93 mm (mean±SD) in the patients with moderate-severe DKA and 4 mm in the single patient with mild DKA. The ONSDs of the two patients with BE on the CT were 6.8 mm and 5.9 mm. The mean ONSD of the five patients with severe DKA was 4.4±0.32 mm in the outpatient clinic checks. Conclusion: The measurement of ONSD by USG may be a supportive method for predicting BE in children with DKA. |
| format | Article |
| id | doaj-art-c261e5cc44d342a9b45a149d2265217e |
| institution | Kabale University |
| issn | 1305-6441 |
| language | English |
| publishDate | 2022-03-01 |
| publisher | Istanbul University Press |
| record_format | Article |
| series | İstanbul Tıp Fakültesi Dergisi |
| spelling | doaj-art-c261e5cc44d342a9b45a149d2265217e2025-08-20T03:52:47ZengIstanbul University Pressİstanbul Tıp Fakültesi Dergisi1305-64412022-03-0185227027410.26650/IUITFD.972539123456CAN BRAIN EDEMA BE PREDICTED WITH OPTIC NERVE SHEATH DIAMETER MEASUREMENT IN CASES WITH DIABETIC KETOACIDOSIS?: A PRELIMINARY STUDYÖzlem Tolu Kendir0https://orcid.org/0000-0002-7580-405XHayri Levent Yılmaz1https://orcid.org/0000-0003-0873-9814Nilgün Erkek2https://orcid.org/0000-0003-0271-232XSinem Sarı Gökay3https://orcid.org/0000-0002-8585-1626Rıza Dinçer Yıldızdaş4https://orcid.org/0000-0003-0739-5108Bilgin Yüksel5https://orcid.org/0000-0003-4378-3255Çukurova Üniversitesi, Adana, TurkiyeÇukurova Üniversitesi, Adana, TurkiyeAkdeniz Üniversitesi, Antalya, TurkiyeSağlık Bakanlığı, Ankara, TurkiyeÇukurova Üniversitesi, Adana, TurkiyeÇukurova Üniversitesi, Adana, TurkiyeObjective: The clinical signs and symptoms of brain edema resulting from diabetic ketoacidosis (DKA) may not always be ob vious. When the intracranial pressure increases, the optic nerve sheath diameter (ONSD) simultaneously increases and can be imaged with ultrasonography. We aimed to discuss the determinative features of ONSD measurements in brain edema (BE) in DKA. Materials and Methods: Patients who were classified as having mild, moderate and severe DKA were included in the study. Transorbital ultrasonography was performed during the first two hours of treatment while the patients remained in the supine neutral position with their eyes closed. The optic nerve sheath diameters, which appeared as a hypoechoic double-edged line 3 mm deep to the globe, were measured. The same measurements were repeated in outpatient clinic controls. The ONSD values and metabolic, neurological conditions of the patients were compared. Results: Eight patients with a mean age of 8.8±3 (Standard Deviation (SD)) years were included in the study. Seven of them presented with moderate to severe DKA. Two patients suffering from headaches were found to have mild BE according to the brain computerized tomography (CT). The ONSD was 5.7±0.93 mm (mean±SD) in the patients with moderate-severe DKA and 4 mm in the single patient with mild DKA. The ONSDs of the two patients with BE on the CT were 6.8 mm and 5.9 mm. The mean ONSD of the five patients with severe DKA was 4.4±0.32 mm in the outpatient clinic checks. Conclusion: The measurement of ONSD by USG may be a supportive method for predicting BE in children with DKA.https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/4EC4987C153A4308BC3B76CB4894198Ediabetic ketoacidosisoptic nerve sheath diameter measurementbrain edema |
| spellingShingle | Özlem Tolu Kendir Hayri Levent Yılmaz Nilgün Erkek Sinem Sarı Gökay Rıza Dinçer Yıldızdaş Bilgin Yüksel CAN BRAIN EDEMA BE PREDICTED WITH OPTIC NERVE SHEATH DIAMETER MEASUREMENT IN CASES WITH DIABETIC KETOACIDOSIS?: A PRELIMINARY STUDY İstanbul Tıp Fakültesi Dergisi diabetic ketoacidosis optic nerve sheath diameter measurement brain edema |
| title | CAN BRAIN EDEMA BE PREDICTED WITH OPTIC NERVE SHEATH DIAMETER MEASUREMENT IN CASES WITH DIABETIC KETOACIDOSIS?: A PRELIMINARY STUDY |
| title_full | CAN BRAIN EDEMA BE PREDICTED WITH OPTIC NERVE SHEATH DIAMETER MEASUREMENT IN CASES WITH DIABETIC KETOACIDOSIS?: A PRELIMINARY STUDY |
| title_fullStr | CAN BRAIN EDEMA BE PREDICTED WITH OPTIC NERVE SHEATH DIAMETER MEASUREMENT IN CASES WITH DIABETIC KETOACIDOSIS?: A PRELIMINARY STUDY |
| title_full_unstemmed | CAN BRAIN EDEMA BE PREDICTED WITH OPTIC NERVE SHEATH DIAMETER MEASUREMENT IN CASES WITH DIABETIC KETOACIDOSIS?: A PRELIMINARY STUDY |
| title_short | CAN BRAIN EDEMA BE PREDICTED WITH OPTIC NERVE SHEATH DIAMETER MEASUREMENT IN CASES WITH DIABETIC KETOACIDOSIS?: A PRELIMINARY STUDY |
| title_sort | can brain edema be predicted with optic nerve sheath diameter measurement in cases with diabetic ketoacidosis a preliminary study |
| topic | diabetic ketoacidosis optic nerve sheath diameter measurement brain edema |
| url | https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/4EC4987C153A4308BC3B76CB4894198E |
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