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颅脑外伤患者颅内压变化与脑电图改变的相关性(作者译)

[Correlations between intracranial pressure variations and EEG changes in patients with cranial trauma (author's transl)].

作者信息

Guieu J D, Lapierre M, Blond S, Hurtevent J F, Jomin M, Pruvot P

出版信息

Rev Electroencephalogr Neurophysiol Clin. 1979 Apr-Jun;9(2):194-201. doi: 10.1016/s0370-4475(79)80075-1.

Abstract

Polygraphic studies were performed over periods of 14 to 76 hours in 30 patients with reccent closed cranial injuries. Correlations between ICP and EEG findings were rarely found (3/16) in cases of cerebral dysfunction of mesodiencephalic or lower levels, where both ICP and EEG were usually stable. Correlations are regularly found in diencephalic or higher (10/14) levels and their presence is of favourable prognostic significance. Generally, delta waves at 1,5-2 cs, high in amplitude (type A) accompany reduced or low ICP levels,while a rapid and low voltage tracing (type B) is associated with raised or high levels of ICP. In the latter cases, a very slow (0.5 cs) and low in amplitude tracing (type C) can progressively replace the type B. The classical periodic or alternating tracing associates alternate sequences of type A and B and is observed simultaneously with type B pressure waves. These correlations are analogous with those observed during the evolution of intracranial tumors or hydrocephalus. The EEG modifications are probably related more to the pathological lesion than to a direct action of fluctuations in ICP.

摘要

对30例近期闭合性颅脑损伤患者进行了长达14至76小时的多导睡眠图研究。在中脑或更低水平的脑功能障碍病例中,很少发现颅内压(ICP)与脑电图(EEG)结果之间的相关性(3/16),此时ICP和EEG通常都很稳定。在间脑或更高水平(10/14)经常发现相关性,其存在具有良好的预后意义。一般来说,1.5 - 2赫兹、高振幅的δ波(A型)伴随着降低或低水平的ICP,而快速低电压描记图(B型)与升高或高水平的ICP相关。在后一种情况下,非常缓慢(0.5赫兹)且低振幅的描记图(C型)可逐渐取代B型。经典的周期性或交替性描记图伴有A型和B型的交替序列,并且与B型压力波同时出现。这些相关性与颅内肿瘤或脑积水进展过程中观察到的相关性类似。EEG改变可能更多地与病理病变有关,而不是与ICP波动的直接作用有关。

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