Quantitative EEG After Subarachnoid Hemorrhage Predicts Long-Term Functional Outcome
| Autor: | Jelena Jukic, Stephan Rampp, Stefan Schwab, Tamara Müller, Dominik Madžar, Mareike Hagge, Johannes Lang, Müjgan Dogan Onugoren, Hajo M. Hamer, Rüdiger Hopfengärtner, Hagen B. Huttner, Stephanie Gollwitzer, Jasmin Merkel |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Subarachnoid hemorrhage Critical Care Physiology Ischemia Electroencephalography 050105 experimental psychology Brain Ischemia 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale Physiology (medical) Internal medicine medicine Humans Vasospasm Intracranial 0501 psychology and cognitive sciences Prospective Studies Prospective cohort study Retrospective Studies medicine.diagnostic_test business.industry 05 social sciences Brain Vasospasm Retrospective cohort study Middle Aged Subarachnoid Hemorrhage Prognosis medicine.disease Neurophysiological Monitoring Transcranial Doppler Neurology Disease Progression Cardiology Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Clinical Neurophysiology. 36:25-31 |
| ISSN: | 0736-0258 |
| DOI: | 10.1097/wnp.0000000000000537 |
| Popis: | Purpose: Delayed cerebral ischemia is a major complication after subarachnoid hemorrhage. Our previous study showed that alpha power reduction in continuous quantitative EEG predicts delayed cerebral ischemia. In this prospective cohort, we aimed to determine the prognostic value of alpha power in quantitative EEG for the long-term outcome of patients with subarachnoid hemorrhage. Methods: Adult patients with nontraumatic subarachnoid hemorrhage were included if admitted early enough for EEG to start within 72 hours after symptom onset. Continuous six-channel EEG was applied. Unselected EEG signals underwent automated artifact rejection, power spectral analysis, and detrending. Alpha power decline of ≥40% for ≥5 hours was defined as critical EEG event based on previous findings. Six-month outcome was obtained using the modified Rankin scale. Results: Twenty-two patients were included (14 male; mean age, 59 years; Hunt and Hess grade I–IV; duration of EEG monitoring, median 14 days). Poor outcome (modified Rankin scale, 2–5) was noted in 11 of 16 patients (69%) with critical EEG events. All six patients (100%) without EEG events achieved an excellent outcome (modified Rankin scale 0, 1) (P = 0.0062; sensitivity 100%, specificity 54.5%). Vasospasm detected with transcranial Doppler/Duplex sonography appeared 1.5 days after EEG events and showed weaker association with outcome (P = 0.035; sensitivity 100%, specificity 45.5%). There was no significant association between EEG events and ischemic lesions on imaging (P = 0.1). Also, no association between ischemic lesions and outcome was seen (P = 0.64). Conclusions: Stable alpha power in quantitative EEG reflects successful therapy and predicts good functional outcome after subarachnoid hemorrhage. Critical alpha power reduction indicates an increased risk of poor functional outcome. |
| Databáze: | OpenAIRE |
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