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Updated: Aug 30, 2026
Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates
Published on: September 6, 2017
Progressive posthemorrhagic hydrocephalus leads to changes of amplitude-integrated EEG activity in preterm infants
M Olischar1, K Klebermass, S Kuhle
1Department of Neonatology and Pediatric Intensive Care, Vienna University Children's Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Insights
Amplitude-integrated electroencephalography (aEEG) monitoring revealed changes in brain activity in preterm infants with posthemorrhagic hydrocephalus (PPH). This neurophysiological surveillance may aid in managing PPH and optimizing intervention timing.
Area of Science:
- Neonatal Neurology
- Neurophysiology
- Pediatric Neurosurgery
Background:
- Intraventricular hemorrhage (IVH) is a common cause of brain lesions in preterm infants.
- Posthemorrhagic hydrocephalus (PPH) develops in approximately 35% of infants with IVH, potentially causing secondary brain injury.
- Current interventions for increased intracranial pressure in PPH are invasive and carry significant risks.
Purpose of the Study:
- To report the novel observation of changes in amplitude-integrated electroencephalography (aEEG) activity in preterm infants with progressive posthemorrhagic hydrocephalus (PPH).
- To explore the potential utility of aEEG for monitoring neurophysiological changes associated with PPH.
Main Methods:
- Continuous cerebral activity monitoring using amplitude-integrated electroencephalography (aEEG).
- Study involved two preterm infants diagnosed with posthemorrhagic hydrocephalus (PPH).
Main Results:
- Increasing ventricular width correlated with increased aEEG discontinuity and loss of sleep-wake cycling in both infants.
- One infant exhibited an abrupt shift to a nearly isoelectric aEEG pattern preceding clinical signs of increased intracranial pressure.
- Clinical signs of increased intracranial pressure manifested 6-12 hours after observed aEEG changes.
- Successful shunting and intracranial pressure reduction led to normalization of aEEG activity in one patient.
Conclusions:
- Continuous neurophysiological monitoring with aEEG may be valuable for the diagnosis and management of preterm infants experiencing progressive PPH.
- aEEG can provide early insights into evolving intracranial pressure dynamics in PPH.
- This monitoring technique may assist in determining the optimal timing for therapeutic interventions in PPH.
Aim:
Intraventricular hemorrhage (IVH) is the most common cause of brain lesions in preterm infants. Among infants with IVH about 35% develop posthemorrhagic hydrocephalus (PPH) which may lead to secondary injury. Therapeutic interventions to reduce the increased intracranial pressure are invasive and carry a high risk of complications. Amplitude-integrated EEG (aEEG) allows continuous neurophysiological surveillance and may help in defining the optimal timing for intervention in infants with progressive PHH. In this report we show, for the first time, a change in aEEG activity in two preterm infants with PHH.
Methods:
Cerebral activity was continuously monitored by aEEG provided by the Cerebral Function Monitor (Lectromed, UK) in two preterm infants with PPH.
Results:
With increasing ventricular width, aEEG showed an increased discontinuity without distinguishable sleep-wake cycling in both infants. One infant showed an abrupt onset of a nearly isoelectric pattern without any change in clinical condition. Clinical signs of increased intracranial pressure developed 6-12 h later in both children. In one patient, aEEG activity returned to normal after successful shunting and reduction of intracranial pressure.
Conclusion:
Continuous neurophysiological monitoring by aEEG may be of value in the diagnostic and therapeutic management of preterm infants with progressive PHH.
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