Rumpl E, Gerstenbrand F, Hackl J M, Lorenzi E, Aichner F
Rev Electroencephalogr Neurophysiol Clin. 1979 Apr-Jun;9(2):131-8. doi: 10.1016/s0370-4475(79)80067-2.
One hundred and sixty-five EEGs were analysed from 140 patients in postraumatic coma with secondary traumatic midbrain and bulbar syndrome. The EEG-pattern was related to the stage of midbrain of bulbar syndrome caused by supratentorial brain shift. There was a close relation between EEG-pattern and the grade of rostro-caudal impairment. A decrease in the number of different EEG-patterns was associated with increasing intra-cranial pressure. An unfavourable state of coma was indicated by the disappearance of sleep or sleep-like activities, alternating pattern and loss of reactivity. In deep stages of coma the neurological examination reveals no lateralizing signs at all. The EEG gives the only hint to a local cerebral lesion. EEG-abnormalities due to the herniation itself interferred with the EEG-changes due to secondary circulatory, respiratory and metabolic encephalopathies. In such cases the above mentioned regularities were blurred.
对140例创伤后昏迷并伴有继发性创伤性中脑和延髓综合征患者的165份脑电图进行了分析。脑电图模式与幕上脑移位引起的延髓综合征中脑阶段相关。脑电图模式与头尾向损伤程度密切相关。不同脑电图模式数量的减少与颅内压升高有关。睡眠或类睡眠活动消失、交替模式和反应性丧失提示昏迷状态不佳。在昏迷的深度阶段,神经学检查根本没有发现定位体征。脑电图是提示局部脑损伤的唯一线索。脑疝本身引起的脑电图异常干扰了继发性循环、呼吸和代谢性脑病引起的脑电图变化。在这种情况下,上述规律变得模糊不清。