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连续定量脑电图 (EEG) 监测在大面积半球梗死 (LHI) 中早期发现脑疝:病例报告。

Continuous Quantitative Electroencephalogram (EEG) Monitoring for Early Detection of Brain Herniation in Large Hemispheric Infarction (LHI): A Case Report.

机构信息

Neurocritical care unit, Department of Neurology, The Second Hospital of Hebei Medical University, 215 Heping West Road, Xinhua District, Shijiazhuang, Hebei 050000, China.

Department of Neurology, Shenze county hospital, Shijiazhuang, Hebei, China.

出版信息

J Stroke Cerebrovasc Dis. 2022 Jan;31(1):106158. doi: 10.1016/j.jstrokecerebrovasdis.2021.106158. Epub 2021 Oct 21.

Abstract

BACKGROUND

Computer-assisted electroencephalography (EEG) systems may improve the likelihood of detecting abnormal EEGs in adult patients with severe disease.

CASE PRESENTATION

We implemented long-range EEG monitoring in a patient with large hemispheric infarction (LHI) and explored its real-time changes in reflecting the patient's brain function. The bands of Alpha, Beta, Delta, Theta, DAR (Delta/Alpha), DTABR (Delta+Theta/Alpha+Beta), and brain symmetry index (BSI) were calculated as a ratio of total power. The test results showed that this patient presents a progressive worsening trend and developed brain herniation. The sigh at the electrophysiological level of brain herniation could be seen 6 h in advance based on the quantitative EEG (QEEG) parameters test. We calculated QEEG at both C3 and C4, electrode locations simultaneously, and the results showed that the trend of QEEG at both electrodes was consistent with the global, affected, and unaffected side.

CONCLUSIONS

QEEG parameters can reflect the trend of LHI patients in real-time and may predict the occurrence of LHI brain herniation. For LHI patients, monitoring with fewer EEG electrodes can be tried to predict the changes in conditions.

摘要

背景

计算机辅助脑电图(EEG)系统可提高检测重症成年患者异常脑电图的可能性。

病例介绍

我们对大面积半球梗死(LHI)患者实施了远程 EEG 监测,并探讨了其实时变化在反映患者脑功能方面的作用。计算了 Alpha、Beta、Delta、Theta、DAR(Delta/Alpha)、DTABR(Delta+Theta/Alpha+Beta)和脑对称指数(BSI)等频段作为总功率的比值。测试结果表明,该患者呈现进行性恶化趋势,并发生脑疝。基于定量脑电图(QEEG)参数测试,在电生理水平上可以提前 6 小时观察到脑疝的迹象。我们同时计算了 C3 和 C4 两个电极位置的 QEEG,结果表明两个电极的 QEEG 趋势与整体、受累侧和未受累侧一致。

结论

QEEG 参数可以实时反映 LHI 患者的趋势,可能预测 LHI 脑疝的发生。对于 LHI 患者,可以尝试使用较少的 EEG 电极进行监测,以预测病情变化。

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