Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
Neurosci Bull. 2012 Oct;28(5):611-7. doi: 10.1007/s12264-012-1265-z. Epub 2012 Sep 11.
To compare electroencephalogram (EEG) symmetry values between stroke patients with different 28-day outcomes, and to assess correlations between clinical characteristics and 28-day outcomes.
Twenty-two patients presenting with acute ischemic stroke and persistent neurological deficits at EEG recording were incrementally included. At 28 days after admission, the modified Rankin scale (mRS) was used to evaluate the outcomes, based on which the patients were divided into two a posteriori groups, mRS = 6 and mRS <6. Student's t-test was used to compare these two groups in terms of brain symmetry index (BSI), National Institutes of Health stroke scale (NIHSS), Glasgow coma scale (GCS) and acute physiology and chronic health evaluation II (APACHE II) assessed at admission. Then EEG parameters, NIHSS, GCS and APACHE II were correlated with the mRS.
There were significant differences in BSI, NIHSS, GCS, and APACHE II between the two groups. Survivors had lower BSI, NIHSS and APACHE II, and higher GCS values, compared with patients who died within 28 days after admission. Besides, BSI at admission had a positive correlation with mRS at 28 days (r = 0.441, P = 0.040). NIHSS and APACHE II were also correlated with mRS (r = 0.736, P <0.000 1; r = 0.667, P = 0.001, respectively). GCS at admission had a negative correlation with mRS (r = -0.656, P = 0.001).
A higher BSI predicts a poorer short-term prognosis for stroke patients. Acute EEG monitoring may be of prognostic value for 28-day outcomes. The early prediction of functional outcomes after stroke may enhance clinical management and minimize short-term mortality.
比较不同 28 天预后的卒中患者脑电图（EEG）对称性值，并评估临床特征与 28 天预后的相关性。
连续纳入 22 例在 EEG 记录时存在急性缺血性卒中且持续存在神经功能缺损的患者。入院后 28 天，采用改良 Rankin 量表（mRS）评估结局，根据 mRS 将患者分为预后不良组（mRS=6）和预后良好组（mRS<6）。采用 Student's t 检验比较两组患者入院时的脑对称性指数（BSI）、美国国立卫生研究院卒中量表（NIHSS）、格拉斯哥昏迷量表（GCS）和急性生理学与慢性健康评估 II （APACHE II）。然后将 EEG 参数、NIHSS、GCS 和 APACHE II 与 mRS 进行相关性分析。
两组患者的 BSI、NIHSS、GCS 和 APACHE II 存在显著差异。与入院后 28 天内死亡的患者相比，幸存者的 BSI、NIHSS 和 APACHE II 较低，GCS 较高。此外，入院时的 BSI 与 28 天的 mRS 呈正相关（r=0.441，P=0.040）。NIHSS 和 APACHE II 与 mRS 也呈正相关（r=0.736，P<0.0001；r=0.667，P=0.001）。入院时的 GCS 与 mRS 呈负相关（r=-0.656，P=0.001）。
较高的 BSI 预示着卒中患者短期预后较差。急性 EEG 监测对 28 天预后可能具有预测价值。对卒中后功能结局的早期预测可以增强临床管理并降低短期死亡率。
