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Updated: Aug 6, 2026
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Early electroencephalography in acute ischemic stroke: prediction of a malignant course?
Lothar Burghaus1, Rüdiger Hilker, Christian Dohmen
1Department of Neurology, University Hospital, Kerpener Str. 62, 50924 Cologne, Germany. lburghaus@gmx.de
Objective:
In patients with large middle cerebral artery (MCA) infarction space occupying brain edema may lead to a malignant course with up to 80% mortality under conservative treatment. As interventional treatment strategies must be started before the deterioration occurs predictors of a malignant course are necessary.
Patients And Methods:
This study reports on the results of early electroencephalography (EEG) within 24h after onset of stroke in 25 patients suffering a large MCA infarct (12 patients with a malignant and 13 with a non-malignant course). EEG analysis was performed according well-established indicators for focal as well as global changes.
Results:
Our findings indicate that the absence of delta activity and the presence of theta and fast beta frequencies within the focus predict a benign course (p < 0.05), whereas diffuse generalized slowing and slow delta activity in the ischemic hemisphere may point to a malignant course.
Conclusion:
This study shows that in patients suffering from large MCA infarction early EEG delivers useful information to select those patients who develop malignant edema.
