Diagnostic value of the integral assessment of electroencephalographic pattern in patients in the acute period of spontaneous supratentorial intracerebral hemorrhage

Abstract

The main purpose of the study was to verify the diagnostic informative value of the integral evaluation of the electroencephalographic pattern in patients with spontaneous supratentorial intracerebral hemorrhage (SSICH) on the basis of the comparison of brain activity changes with clinical and neuroimaging data. Material and methods. Prospective cohort study of 46 patients in acute period of SSICH was conducted. It included complex clinical (using Glasgow Coma Scale, Full Outline of UnResponsiveness (FOUR) score, National Institute of Health Stroke Scale, Intracerebral hemorrhage score) and neuroimaging estimation of cerebral injury severity in the onset of the disease. Investigation of brain bioelectrical activity was made during first 24-48 hours from the onset with determination of average absolute spectral rhythm power (AASRP), relative spectral rhythm power (RSRP), fronto-occipital rhythm gradient (FORG) in the affected hemisphere (AH) and intact hemisphere (IH), interhemispheric rhythm asymmetry values. Results. On the basis of cluster analysis 2 types of the brain bioelectric activity changes were identified in patients with SSICH. Type I of EEG pattern was registered in 56.5 % patients, it was characterized by ipsilateral increase of RSRP of δ-range with the dominance of θ-range rhythms in slow-wave activity structure in combination with smoothing of zonal differences of α-range rhythms in AH, whereas type II was characterized by bilateral domination of the RSRP δ-range with an accent in IH in combination with FORG inversion of α-range due to elevation of the α2-subrange in the anterior areas of IH. The patients with type II of EEG pattern were characterized by ipsilateral increase of RSRP of δ-range with the dominance of θ-range rhythms in slow-wave activity structure in combination with smoothing of zonal differences of α-range rhythms in AH. The patients with type II of EEG pattern were characterized by more severe brain impairment (ICH score 3 (2; 4) versus 0 (0; 1), P < 0.0001). Type II of EEG pattern was revealed in 94.7 % of patients with medium/severe dysfunction of subtentorial structures (FOUR score ≤14), type I-in 92.6 % of patients with low dysfunction or without any dysfunction (FOUR score >14). Conclusions. Complex analysis of bioelectric activity of the brain in patients with SSICH allows to identify the integral types of EEG pattern, which represent the functional state of cerebral structures and are associated with the clinical and neuroimaging criteria of midline shift severity. Діагностичне значення інтегральної оцінки ЕЕГ-патерну в пацієнтів у гострому періоді спонтанного супратенторіального внутрішньомозкового крововиливу А. А. Кузнєцов Мета роботи-визначити діагностичну інформативність інтегральної оцінки електроенцефалографічного (ЕЕГ) патерну в пацієнтів зі спонтанним супратенторіальним внутрішньомозковим крововиливом (ССВМК) на підставі зіставлення показників біоелектричної активності головного мозку з клініко-нейровізуалізаційними даними. Матеріали та методи. Здійснили проспектив...