Prognostic value of electroencephalography and evoked potentials in the early course of malignant middle cerebral artery infarction

Peer Review #1 of "Slower EEG alpha generation, synchronization and “flow”—possible biomarkers of cognitive impairment and neuropathology of minor stroke (v0.1)"

“…2). Although, the stroke induced slowing of EEG is well documented (Burghaus et al, 2013;Finnigan et al, 2016;Jordan, 2004), in our study the alpha slowing was followed by theta amplitude augmentation and beta amplitude attenuation, particularly over the frontal cortex. In addition, the minor stroke induced long-term alpha inter-hemispheric Manuscript to be reviewed synchronization within the frontal cortex, followed by permanent delta, theta, beta, and gamma inter-hemispheric desynchronization within the parietal and temporal cortex (Fig.…”

“…These alterations can be observed as specific EEG patterns over the ischemic area, coming from the attenuation of faster (alpha and beta) and the augmentation of slower (delta and theta) frequency bands (Jordan, 2004;Nagata et al, 1989). Apart from being very sensitive in the detection of cerebral ischemia, EEG can also be used as a diagnostic and prognostic tool, or to track therapy during stroke recovery (Burghaus et al, 2013;Finnigan and van Putten, 2013;Finnigan et al, 2016;Foreman and Claassen, 2012). Namely, according to recent studies, the quantitative measures of specific EEG features (qEEG) are even more sensitive than raw EEG, and well correlated with stroke severity and radiographic findings (Finnigan et al, 2004;Sheorajpanday et al, 2011), response to PeerJ reviewing PDF | (2017:04:17376:2:0:CHECK 21 Aug 2017)…”

“…Manuscript to be reviewed treatment such as thrombolytic therapy (Finnigan et al, 2006), and to functional outcomes (Burghaus et al, 2013;Finnigan et al, 2004).…”

Recommendations on the use of EEG monitoring in critically ill patients: consensus statement from the neurointensive care section of the ESICM

“…Prognostication Following hemicraniectomy for spaceoccupying middle cerebral artery infarction, the presence of faster EEG activity was associated with good recovery in patients monitored with cEEG [50]. Three studies have demonstrated that the disappearance or further slowing of delta activity in the acute phase (within 24 h) of AIS predicted a malignant course (cerebral edema) [51][52][53]. Preliminary studies showed a correlation between the neurological score in the acute stage of AIS and the degree of EEG abnormality [54], although this correlation was shown to be low by others [ Recommendations for comatose patients after CA 1.…”

Hemicraniectomy for Malignant Middle Cerebral Artery Infarction: Current Status and Future Directions

“…The retrospective single‐center experience is also the major drawback of electrophysiological studies on electroencephalogram (EEG), evoked potentials (EPs), and autonomic function that found moderate predictive values of the coexistence of background slowing on EEG, pathological brainstem auditory EP, and a decreased baroreflex sensitivity . Studies investigating multimodal neuro‐biochemical monitoring, EEG power spectrum, and cortical spreading depolarization require invasive procedures and are not available in many centers in clinical routine or outside an experienced intensive care unit.…”