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Published on: September 16, 2017
Routine EEG with quantitative analysis to detect delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage
Marina S Cherchi1, Miguel A Hernández-Hernández1, Javier Hernández-Cabello2
1Department of Intensive Medicine. Marqués de Valdecilla University Hospital. Santander, Cantabria 39008, Spain; Biomedical Research Institute (IDIVAL), Santander, Cantabria 39011, Spain.
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.
