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三相波与颅内压的关系作为创伤性脑损伤中一种可能的预后标志物

The Relationship of Triphasic Waves with Intracranial Pressure as a Possible Prognostic Marker in Traumatic Brain Injury.

作者信息

Katyal Nakul, Sarwal Aarti, George Pravin, Banik Biswajit, Newey Christopher R

机构信息

Department of Neurology, University of Missouri, 5 Hospital Drive, CE 540, Columbia, MO 65211, USA.

Wake Forest University School of Medicine, Neurology and Critical Care (Anesthesia), Reynolds M, Medical Center Blvd, Winston-Salem, NC 27157, USA.

出版信息

Case Rep Neurol Med. 2017;2017:4742026. doi: 10.1155/2017/4742026. Epub 2017 Nov 28.

DOI:10.1155/2017/4742026
PMID:29318067
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5727623/
Abstract

BACKGROUND

Continuous electroencephalography (CEEG) monitoring is used for detection of convulsive and nonconvulsive seizures and assessing the degree of encephalopathy in critically ill patients. A commonly seen encephalopathic pattern on CEEG is generalized periodic discharges with triphasic wave (TW) morphology. The underlying role and prognostic significance of TW in relationship to intracranial pressure (ICP) remain unknown. We present a case highlighting the relationship of TW with ICP in a case with severe traumatic brain injury (TBI).

METHOD

Case report.

RESULTS

A patient with severe TBI and no underlying metabolic abnormalities was admitted to the neurocritical care unit. TW were seen on CEEG. The TW diminished during episodes of intracranial hypertension but reappeared with reduction of the intracranial pressure.

CONCLUSION

This study highlights a possible favorable prognostic marker of finding TW in a patient with intracranial hypertension. We have proposed a preliminary understanding of the relationship between TW and intracranial hypertension, which may be helpful in formulating future studies involving larger cohorts.

摘要

背景

连续脑电图（CEEG）监测用于检测危重症患者的惊厥性和非惊厥性癫痫发作，并评估脑病程度。CEEG上常见的一种脑病模式是具有三相波（TW）形态的广泛性周期性放电。TW与颅内压（ICP）相关的潜在作用和预后意义尚不清楚。我们报告一例严重创伤性脑损伤（TBI）病例，突出显示了TW与ICP之间的关系。

方法

病例报告。

结果

一名无潜在代谢异常的严重TBI患者入住神经重症监护病房。CEEG上可见TW。TW在颅内高压发作期间减少，但随着颅内压降低而再次出现。

结论

本研究强调了在颅内高压患者中发现TW可能是一个良好的预后标志物。我们对TW与颅内高压之间的关系提出了初步认识，这可能有助于开展未来涉及更大队列的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3fe/5727623/7128e44c7787/CRINM2017-4742026.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3fe/5727623/6c7aae40dacd/CRINM2017-4742026.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3fe/5727623/e27546e7bf39/CRINM2017-4742026.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3fe/5727623/7128e44c7787/CRINM2017-4742026.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3fe/5727623/6c7aae40dacd/CRINM2017-4742026.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3fe/5727623/e27546e7bf39/CRINM2017-4742026.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3fe/5727623/7128e44c7787/CRINM2017-4742026.003.jpg

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