Quantitative EEG alterations after isovolemic-hemodilutional augmentation of cerebral perfusion in stroke patients

Eleven patients with ischemic neurologic deficits in the middle cerebral arterial (MCA) territory and ipsilateral slowing on initial EEG underwent venesection and equal volume replacement with intravenous 5% human serum albumin. As the mean hematocrit was reduced by 19%, the mean cerebral blood flow (CBF) in the MCA territory of the affected and contralateral hemisphere determined by the 133Xenon inhalation technique increased 18 and 21%, respectively. Similarly, CBF in the contralateral occipital region increased 17%. The percentage total slow-wave EEG activity (fractional sum of theta and delta activity, 1.0 to 7.5 Hz) determined by fourier analysis was reduced significantly in the affected MCA territory and in the contralateral occipital region within 1 to 2 hours after isovolemic hemodilution. Using quantitative EEG analysis, rapid improvement in background EEG activity can be demonstrated following the diffuse elevation in CBF by hemodilution.