Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany.
Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany.
Clin Neurophysiol. 2021 Jun;132(6):1283-1289. doi: 10.1016/j.clinph.2021.03.005. Epub 2021 Mar 26.
In subarachnoid hemorrhage (SAH), transcranial Doppler/color-coded-duplex sonography (TCD/TCCS) is used to detect delayed cerebral ischemia (DCI). In previous studies, quantitative electroencephalography (qEEG) also predicted imminent DCI. This study aimed to compare and analyse the ability of qEEG and TCD/TCCS to early identify patients who will develop later manifest cerebral infarction.
We analysed cohorts of two previous qEEG studies. Continuous six-channel-EEG with artefact rejection and a detrending procedure was applied. Alpha power decline of ≥ 40% for ≥ 5 hours compared to a 6-hour-baseline was defined as significant EEG event. Median reduction and duration of alpha power decrease in each channel was determined. Vasospasm was diagnosed by TCD/TCCS, identifying the maximum frequency and days of vasospasm in each territory.
34 patients were included (17 male, mean age 56 ± 11 years, Hunt and Hess grade: I-V, cerebral infarction: 9). Maximum frequencies in TCD/TCCS and alpha power reduction in qEEG were correlated (r = 0.43; p = 0.015). Patients with and without infarction significantly differed in qEEG parameters (maximum alpha power decrease: 78% vs 64%, p = 0.019; summed hours of alpha power decline: 236 hours vs 39 hours, p = 0.006) but showed no significant differences in TCD/TCCS parameters.
There was a moderate correlation of TCD/TCCS frequencies and qEEG alpha power reduction but only qEEG differentiated between patients with and without cerebral infarction.
qEEG represents a non-invasive, continuous tool to identify patients at risk of cerebral infarction.
蛛网膜下腔出血（SAH）患者常采用经颅多普勒超声/彩色双功超声（TCD/TCCS）检测迟发性脑缺血（DCI）。既往研究表明，定量脑电图（qEEG）也可预测即将发生的 DCI。本研究旨在对比并分析 qEEG 和 TCD/TCCS 早期识别即将发生脑梗死患者的能力。
我们对两项既往 qEEG 研究的队列进行了分析。采用带伪迹剔除和去趋势处理的连续 6 通道 EEG。与 6 小时基线相比，α波功率下降≥40%且持续≥5 小时被定义为显著脑电图事件。确定每个通道中 α 波降低的中位数减少量和持续时间。通过 TCD/TCCS 诊断血管痉挛，确定每个区域的最大频率和血管痉挛天数。
纳入 34 例患者（男 17 例，平均年龄 56±11 岁，Hunt 和 Hess 分级：I-V 级，脑梗死：9 例）。TCD/TCCS 中的最大频率和 qEEG 中的α波功率降低呈正相关（r=0.43；p=0.015）。有无脑梗死的患者在 qEEG 参数方面存在显著差异（最大 α 波降低：78%比 64%，p=0.019；α 波功率下降总小时数：236 小时比 39 小时，p=0.006），但 TCD/TCCS 参数无显著差异。
TCD/TCCS 频率与 qEEG α 波功率降低之间存在中等相关性，但只有 qEEG 可区分有无脑梗死的患者。
qEEG 是一种非侵入性、连续的工具，可用于识别有脑梗死风险的患者。
