Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2025
Routine EEG with quantitative analysis to detect delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage.
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Cherchi Marina S, Hernández-Hernández Miguel A, Hernández-Cabello Javier, Díez Eduardo Torres, Orizaola Pedro, Stakhurska-Bilynska Tetyana, Martín-Láez Rubén, Fernández-Torre José L
Аннотация
OBJECTIVE: To assess the ability of routine electroencephalography (rEEG) to predict delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH).
METHODS: Single-center prospective study including adult patients with aSAH. Two rEEG recordings with quantitative analysis and transcranial Doppler sonography (TCD) were performed, within the first 72 h (EEG1 and TCD1) and between days 4-7 (EEG2 and TCD2). Multivariate logistic regression was performed to identify DCI predictors.
RESULTS: Seventeen (25.4 %) of 67 patients developed DCI. In qualitative analysis, no patient with a normal EEG1 had DCI, while in EEG2, the absence of bilateral posterior alpha rhythm was more frequently observed in patients with DCI (52.9 % vs 20 %; p = 0.009). Quantitative EEG2 analysis revealed significantly higher total, delta, and theta power in DCI patients, with lower alpha-beta/theta-delta ratio and edge. Delta power ≥ 4.5 μV in EEG2 showed higher sensitivity than vasospasm on TCD2 but lower specificity. Age (OR 1.08; p = 0.04), vasospasm on TCD2 (OR 41.01; p = 0.003) and delta power ≥ 4.5 μV in EEG2 (OR 4.30; p = 0.06) were independent predictors of DCI.
CONCLUSIONS: rEEG with quantitative analysis is a useful tool for predicting DCI.
SIGNIFICANCE: Integration of rEEG and TCD may improve detection of DCI in aSAH patients.
METHODS: Single-center prospective study including adult patients with aSAH. Two rEEG recordings with quantitative analysis and transcranial Doppler sonography (TCD) were performed, within the first 72 h (EEG1 and TCD1) and between days 4-7 (EEG2 and TCD2). Multivariate logistic regression was performed to identify DCI predictors.
RESULTS: Seventeen (25.4 %) of 67 patients developed DCI. In qualitative analysis, no patient with a normal EEG1 had DCI, while in EEG2, the absence of bilateral posterior alpha rhythm was more frequently observed in patients with DCI (52.9 % vs 20 %; p = 0.009). Quantitative EEG2 analysis revealed significantly higher total, delta, and theta power in DCI patients, with lower alpha-beta/theta-delta ratio and edge. Delta power ≥ 4.5 μV in EEG2 showed higher sensitivity than vasospasm on TCD2 but lower specificity. Age (OR 1.08; p = 0.04), vasospasm on TCD2 (OR 41.01; p = 0.003) and delta power ≥ 4.5 μV in EEG2 (OR 4.30; p = 0.06) were independent predictors of DCI.
CONCLUSIONS: rEEG with quantitative analysis is a useful tool for predicting DCI.
SIGNIFICANCE: Integration of rEEG and TCD may improve detection of DCI in aSAH patients.