Early Electroencephalography in Acute Ischemic Stroke: Prediction of a Malignant Course?

Burghaus, Lothar; Dohmen, C.; Bosche, Bert; Galldiks, Norbert; Winhuisen, Lutz; Szelies, B.; Haupt, W F

doi:10.1055/s-2006-939114

Cited by 7 publications

(10 citation statements)

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“…Because cortical changes are modulated by brainstem reticular formations, global changes, such as loss of reactivity [21] and lack of sleep-wake cycles [22], may portend poor prognosis (and indicate possible brainstem involvement). Regional changes, including a lack of delta or the presence of faster frequencies within 24 hours, correlate with a good outcome [23] while the persistence of unilateral prominent, continuous delta slowing or decreased alpha adds signifi cantly to clinical predictions of poor outcome [24]. Other specifi c patterns may also indicate poor prognosis, such as RAWOD (with up to 67% mortality) [13] or periodic lateralized epileptiform discharges (PLEDs) [25].…”

Section: Eeg Changes In Ischemiamentioning

confidence: 99%

Quantitative EEG for the Detection of Brain Ischemia

Foreman¹,

Claassen²

2012

Annual Update in Intensive Care and Emergency Medicine 2012

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Section: Eeg Changes In Ischemiamentioning

confidence: 99%

Quantitative EEG for the Detection of Brain Ischemia

Foreman¹,

Claassen²

2012

Annual Update in Intensive Care and Emergency Medicine 2012

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“…This activity is thought to be a hallmark involved in the pathological outcome in rat focal ischemia [34][35]. The high-amplitude delta waves are shown to be a common phenomenon of ischemic brain injury also in humans [36][37]. The injection of 60 pmol of ET adjacent to MCA did not trigger electrographic or behavioural seizures until the end of our experiment as opposite to higher dose of ET1 which may lead to non-convulsive seizure activity in EEG within 2 h after the onset of ischemia [25].…”

Section: Discussionmentioning

confidence: 99%

Ketanserin reduces the postischemic EEG and behavioural changes following Endothelin-1-induced occlusion of the middle cerebral artery in conscious rats

et al. 2008

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AbstractWe modeled the common clinical conditions of human stroke in fully conscious rats through an occlusion of the middle cerebral artery (MCAO) by means of unilateral microinjection of Endothelin-1 (ET1) in the vicinity of the artery (EMCAO model). Since the role of serotonin (5-HT) system in the regulation of the cerebral blood flow has been known for long time and no data are available at present for the effects of 5-HT antagonists in focal ischemia models, we further tested whether a blockade of the serotonin-2A (5-HT2A) receptors by ketanserin (20 min post-ET1) would diminish the late EMCAO-induced functional and morphological changes. The long-term neurological (postural reflex) and electroencephalogram (EEG) changes in the somatosensory cortical region (S1FL) were used to assess the effects of ketanserin on the post-ischemic changes. The study was supplemented by a histopathological examination of S1FL area and striatum of both hemispheres. The EMCAO/ ketanserin-treated rats showed much smaller neurological deficits than the EMCAO rats treated with vehicle. This effect was observed on day 3 and lasted until the end of experiments-14 days after EMCAO. The depression of alpha and beta EEG frequencies found after EMCAO was significantly and earlier restored following ketanserin. Notably, there was not augmentation of the pathological slow EEG waves at day 3 post-ET1 in the EMCAO ketanserin-treated rats compared with that observed in the EMCAO vehicle-treated rats. Although there were mild morphological changes in the penumbral S1FL cortical region after EMCAO, ketanserin reduced the histopathological difference between the ipsilateral and contralateral cortical S1FL regions, but did not change the difference between striatum of both sides. Ketanserin reduced the infarct size in ipsilateral hemisphere (mainly cortex). In conclusion, the results showed that treatment with ketanserin at the early stage of stroke may reduce the consequences of ischemia by improvement of functional and morphological recovery at later stages. Ketanserin appears to be a promising candidate for mitigating the consequences of stroke.

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“…[15] Orta serebral arter iskemik infarktlarında, teta ve beta aktivitelerinin varlığının benign seyirle, jeneralize yavaşlama ve delta aktivitelerinin varlığı ise malign seyirle birlikte bulunmuştur. [5] Laküner infarktlarda %53 oranında hafif EEG anomalileri saptanmıştır. Bunların %13'ünde bulgular ipsilateral ve fokal olarak bulunmuştur.…”

Section: Discussionunclassified

“…Çalışmalarda etyolojisi farklı bilinç bozukluğu tablolarında, prognoz ile EEG bulguları-nın ilişkisine dikkat çekilmektedir. [3][4][5] Bunlardan, periyodik lateralize epileptiform deşarjların (PLED) akut ya da subakut serebral hastalık süreçleri ile birlikte olduğu ve kötü prognoza işaret ettiği bildirilmektedir. [6][7][8] Glaskow koma ölçeği (GKÖ) strok başta olmak üzere şuur bozukluğunun eşlik ettiği nörolojik hastalıkların ciddiyetini belirlemede ve takibinde kullanılan kısa ve kolay bir ölçek-tir.…”

Section: Introductionunclassified

Non-epileptic Acute Consciousness Disorders: The Clinical And Prognostic Importance Of Electroencephalography

Çınar¹,

Şahin²,

Karşıdağ³

2012

Epilepsi

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ÖzetAmaç: Şuur bozukluğu ile birlikte olan epilepsi dışındaki tablolarda, elektroensefalografi'nin (EEG) hastalık süreci ile ilişkisi net değildir. Bu çalışmada, akut dönemdeki olgularda EEG bulguları ile serebral fonksiyon bozukluğu ölçütleri karşılaştırılarak, tablonun ciddiyeti ile EEG patolojileri arasındaki ilişkinin ortaya konulması amaçlanmıştır. Gereç ve Yöntem:Çalışmaya 2010-2012 yılları arasında acil servise akut bilinç bozukluğu ile getirilen ardışık olgular alındı. Tüm olguların EEG incelemesi ile Glaskow koma ölçeği (GKÖ), puanları değerlendirildi. EEG patolojileri; yavaş dalga aktiviteleri, epileptiform aktiviteler, mikst form, düşük amplütüdlü hızlı beta aktivitesi ve düz aktivite olarak beş grup altında ele alındı. Bulgular:Toplam 113 olgunun yaş ortalaması 70.6±12 yıl olup, kadın erkek oranı 45/68'dir. Olguların %60'ını iskemik inme, %40'nı ensefalopatiler oluşturmaktadır. Epileptiform aktiviteler %74 oranında ensefalopati olgularında, yavaş dalga aktiviteleri ise %69 oranında strok olgularında saptanmıştır. GKÖ puanındaki yükseklik yavaş dalga aktiviteleri ile, düşüklük ise epileptiform dalga aktiviteleri ile ilişkili bulunmuştur.Sonuç: Sonuçlarımız EEG' deki yavaş dalga aktiviteleri ile inme olgularının, epileptiform aktiviteler ile ensefalopati olgularının şuur bozukluğu arasındaki ilişkiye işaret etmektedir. Uzun takip süreli ileri çalışmalar gereklidir.Anahtar sözcükler: Elektroensefalografi; Glaskow koma ölçeği; şuur bozukluğu. SummaryObjectives: The association between non-epileptic consciousness disorders and electroencephalographic (EEG) findings is not clear. In this study we compared the EEG findings and cerebral disfunction criterias in the acute stage of the illness. We aimed to investigate the relationship between the disease severity and the pathological EEG findings. Methods:Patients who were admitted to our emergency ward with acute consciousness disorder between the years of 2010-2012 were enrolled to the study. Glasgow coma scale (GCS), were applied to all cases. EEG abnormalities were classified in five groups; slow-wave activity, epileptiform activity, mixed forms, fast beta activity with low-amplitude and flat trace. Results:The mean age of total 113 cases was 70.6±12 years; female/male ratio was 45/68. Ischemic stroke and encephalopathy ratio was 60% and 40% respectively. The ratio of epileptiform activities was 74% in patients with encephalopathy and the ratio of slow wave activities was %69 in patients with stroke. Higher score of GCS was related with slow wave activities and lower score of GCS was related with epileptiform activities. Conclusion:Our results suggest significant relationship between stroke and slow wave activities, and also between epileptiform activities and encephalopathy based on impairment of consciousness. Further studies with long follow-up period are needed.

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Early Electroencephalography in Acute Ischemic Stroke: Prediction of a Malignant Course?

Cited by 7 publications

References 0 publications

Quantitative EEG for the Detection of Brain Ischemia

Quantitative EEG for the Detection of Brain Ischemia

Ketanserin reduces the postischemic EEG and behavioural changes following Endothelin-1-induced occlusion of the middle cerebral artery in conscious rats

Non-epileptic Acute Consciousness Disorders: The Clinical And Prognostic Importance Of Electroencephalography

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