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[脑电图中的皮层下体征是否是颅内占位性病变导致脑干移位和受压过程的可靠指标?一项计算机断层扫描-脑电图对比研究]

[Are subcortical signs in the EEG a reliable indication of brain stem displacement and impaction processes by intracranial space-occupying processes? A comparative computer tomography-electroencephalography study].

作者信息

Zettler H, Järisch M, Leonhard T

出版信息

Zentralbl Neurochir. 1985;46(1):69-78.

PMID:4013565
Abstract

Within the scope of an elektroencephalographic-computertomographic comperative study carried out in 430 patients, the concurrence of secondary brain stem damage due to mass displacement and herniation processes and parroxysmal generalised slow activity in the EEG ("intermittant frontal delta rhythms", "projected discharges", "subcortical signs") in intracranial space-occupying processes were studied among others. The occurrence of the EEG pattern was independent of the presence of brain stem displacements in about 20 and 25 per cent, respectively, of the 152 patients with supratentorial space occupations. The absence of the characteristics on 80 per cent of the patients with clear CT criteria for a secondary brain stem impairment shows that it is not suitable as a warning sign of an imminent intracranial decompensation and that in particular from the non-occurrence in the EEG no contribution to the operative risk and to the choice of the time of the operation can be derived. A relation between the occurrence of paroxysmal slow activity and the acuity of the course of the disease or the degree of malignity of cerebral tumours could not be verified. Possible causes of the inconstant occurrence of this EEG pattern in brain stem alterations are discussed.

摘要

在对430例患者进行的脑电图 - 计算机断层扫描对比研究范围内,尤其研究了颅内占位性病变中因肿块移位和疝形成过程导致的继发性脑干损伤与脑电图中阵发性全身性慢活动(“间歇性额部δ节律”、“投射性放电”、“皮质下体征”)的并发情况。在152例幕上占位性病变患者中,分别约有20%和25%的患者脑电图模式的出现与脑干移位的存在无关。80%具有明确CT标准显示继发性脑干损伤的患者未出现这些特征,这表明它不适合作为即将发生颅内失代偿的警示信号,特别是从脑电图中未出现这种情况无法推断出对手术风险和手术时机选择的影响。阵发性慢活动的出现与疾病进程的急缓或脑肿瘤的恶性程度之间的关系无法得到证实。文中讨论了这种脑电图模式在脑干改变中出现不恒定的可能原因。

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