Cerebral hemorrhagic infarction was diagnosed subsequently after high-amplitude slow waves detected on processed electroencephalogram during sedation: a case report

Abstract

Background Continuous electroencephalogram (EEG) monitoring is useful for assessing the level of sedation and detecting non-convulsive epileptic seizures and cerebral ischemia in the intensive care unit. This report describes a case of cerebral hemorrhagic infarction diagnosed after the detection of high-amplitude slow waves on processed EEG during sedation. Case presentation A 68-year-old man who underwent cardiac surgery was sedated in the intensive care unit following an invasive procedure. High-amplitude slow waves appeared on processed EEG monitoring before the detection of anisocoria. Computed tomography revealed a cerebral hemorrhagic infarction. Conclusions In the management of critically ill patients, continuous EEG monitoring with forehead electrodes may be useful in the early detection of brain lesions.

Deciphering Post-Stroke Sleep Disorders: Unveiling Neurological Mechanisms in the Realm of Brain Science

“…Overall, stroke causes a significant impact on the microstructure of sleep. [20] acute hemispheric stroke hemispheric TST, low SE, reduced N2 and decreased N3 and N4 NREM sleep [51] raphe nucleus stroke raphe nucleus reduced NREM [6] cerebral hemorrhagic infarction frontal lobe increased δ waves [52] brain stem strokes brainstem highest REM and REM latency [53] brain stem stroke thalamus mesencephalic pontine tegmental reticular formation diminished REM sleep increased NREM sleep [54] ischemic stroke cortex and striatum inhibited REM sleep [55] cerebellar stroke brain stem and hemisphere reduced NREM prolonged REM latency [56] paramedian thalamic stroke paramedian thalamic increased N2 and N3 decreased N4 [57] bilateral thalamic stroke bilateral thalamic NREM sleep instability reduced arousals [58] unilateral diencephalic stroke thalamus excessive sleep decreased N2 and N3 sleep [59] lateral medullary infarction lateral medullary complete sleep suppression [60] middle-aged C57BL/6J mice, MCAO frontoparietal cortex and lateral caudoputamen reduced NREM and REM increased latency to sleep reduced NREM delta power [61] TST = total sleep time; SE = sleep efficiency; MCAO = middle cerebral artery occlusion.…”

Neuromonitoreo con electroencefalograma procesado, más que profundidad anestésica

“…El EEG y los índices pEEG pueden reflejar el resultado de alteraciones fisiopatológicas de los pacientes (18) . Edad, temperatura, hipoxia, hipoglicemia, trastornos hidroelectrolíticos y ácido-base, estados epilépticos no convulsivos, cambios en el FSC por hipovolemia, hipotensión-hipoperfusión o isquemia, pueden alterar el estado de consciencia/inconsciencia y generar cambios en el EEG/pEEG, sus trazos, ondas o «firmas» y sus índices numéricos independientemente de los fármacos anestésicos, dosis y efecto (19)(20)(21) , por lo que su uso permitiría detectar diferentes estados clínicos y patológicos perioperatorios (24) y brindar la posibilidad de evitar posibles complicaciones como delirio o disfunción cognitiva postoperatoria (DCPO) (25)(26)(27)(28)(29) .…”