Koufen H
EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1977 Mar;8(1):29-35.
A systematic follow up study of EEG in 116 children, who after head injury were admitted to a surgical ward and examined within 3 days, the following day and the 30., 90., and 180. day after the trauma gave the following results; 1. EEG examinations indicate traumatic cerebral disturbances (foci 38%, general slowing 47%) nearly twice as often (53%) as neurological examination (30%). 2. 45% of the cases with general slowing may be detected by repeated examinations only because of the variability of the EEG in infancy. 3. Focal signs consisted mainly in delta-foci, in 74% of temporal localisation. S.c. reduction foci without slowing were not found. 4. Skull fractures were mostly combined with EEG changes (10 from 11). 5. Variations in vigilance were significantly more frequent in contusions in the initial stages, hyperventilation changes in the later stages. The reduction of amplitudes was without diagnostic relevance. 6. Normalization of slowing preceeded that of foci in only 23% although focal abnormalities persisted for more than 6 months in 14% and slowing only in 4%. 7. In 60% of the patients with traumatic EEG changes amnesia had not lasted longer than 10 minutes. Amnesias lasting more than 2 hours were always accompanied by EEG abnormalities. 8. Traumatic EEG abnormalities are not missed, if recordings are performed within 3 days and controlled 3 months after the trauma. The problem of the diagnostic classification is discussed and it is recommended, that the notion of contusion is used in a broader sense.
对116名头部受伤后入住外科病房并在伤后3天内、次日以及第30天、90天和180天进行检查的儿童进行了脑电图系统随访研究,结果如下:1.脑电图检查显示创伤性脑功能障碍(病灶38%,普遍减慢47%)的发生率几乎是神经学检查(30%)的两倍(53%)。2.由于婴儿期脑电图的变异性,仅通过重复检查才能发现45%的普遍减慢病例。3.局灶性体征主要表现为δ波病灶,74%位于颞叶。未发现无减慢的继发性减少病灶。4.颅骨骨折大多合并脑电图改变(11例中有10例)。5.在初始阶段,意识改变在挫伤中更为频繁,后期则以过度换气改变为主。波幅降低无诊断意义。6.仅有23%的减慢先于病灶恢复正常,尽管14%的局灶性异常持续超过6个月,而减慢仅持续4%。7.在脑电图有创伤性改变的患者中,60%的遗忘持续时间不超过10分钟。持续超过2小时的遗忘总是伴有脑电图异常。8.如果在伤后3天内进行记录并在伤后3个月进行复查,不会漏诊创伤性脑电图异常。文中讨论了诊断分类问题,并建议更广泛地使用挫伤这一概念。