EEG power spectrum to predict prognosis after hemicraniectomy for space-occupying middle cerebral artery infarction / Jennifer Diedler, Marek Sykora, Eric Jüttler, Roland Veltkamp, Thorsten Steiner, André Rupp

BACKGROUND: Early prediction of outcome after decompressive surgery for space-occupying middle cerebral artery (MCA) infarction is needed to guide further therapy. Here we applied spectral EEG analysis to determine the prognosis early after hemicraniectomy, while the patient is still treated in the intensive care unit. - METHODS: Continuous EEG monitoring following hemicraniectomy was performed in 10 patients with space-occupying MCA infarction. All patients were analgosedated and mechanically ventilated. The first 6 h of monitoring after surgery were evaluated by spectral analysis. Outcome measures included Glasgow Outcome Scale (GOS), Level of Consciousness Scale (LOC) and National Institute of Health Stroke Scale (NIHSS) at discharge. Outcome after 3 months was assessed by modified Rankin Scale. - RESULTS: Six patients displayed a peak at 5-10 Hz in the EEG power spectrum. All these patients had a GOS score of 3 and an LOC score >or=7 at discharge. In contrast, the 4 patients without faster EEG activity had a GOS of 2 and LOC <or=6. GOS (r = 1, p < 0.001), LOC (r = 0.89, p = 0.001) and NIHSS (r = -0.8; p < 0.01) at discharge significantly correlated with the presence of 5- to 10-Hz activity, but not with age, time to hemicraniectomy, duration of hospital stay or baseline NIHSS scores. Outcome after 3 months significantly correlated with age (r = 0.67; p < 0.05) and the presence of faster EEG activity (r = -0.76; p < 0.01). - CONCLUSIONS: Spectral analysis in the subacute phase following hemicraniectomy may represent a parameter to predict early regain of consciousness and thus the capability and potential for further rehabilitation and favorable outcome..

Medienart:

E-Artikel

Erscheinungsjahr:

2010

Erschienen:

2010

Enthalten in:

Zur Gesamtaufnahme - volume:29

Enthalten in:

Cerebrovascular diseases - 29(2010), 2, Seite 162-169

Sprache:

Englisch

Beteiligte Personen:

Diedler, Jennifer, 1977- [VerfasserIn]
Sykora, Marek [VerfasserIn]
Jüttler, Eric, 1972- [VerfasserIn]
Veltkamp, Roland, 1966- [VerfasserIn]
Steiner, Thorsten, 1961- [VerfasserIn]
Rupp, André, 1962- [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Adult
Aged
Analgesics
Consciousness
Critical Care
Decompressive Craniectomy
Disability Evaluation
Electroencephalography
Fourier Analysis
Humans
Hypnotics and Sedatives
Infarction, Middle Cerebral Artery
Length of Stay
Middle Aged
Monitoring, Physiologic
Patient Discharge
Predictive Value of Tests
Recovery of Function
Respiration, Artificial
Signal Processing, Computer-Assisted
Time Factors
Treatment Outcome

Anmerkungen:

Online veröffentlicht: December 1, 2009

Gesehen am 01.03.2024

Umfang:

Illustrationen

8

doi:

10.1159/000262313

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

188234426X