局灶性缺血脑损伤EEG信号的时频分析

本文提出了一个局灶性缺血脑损伤实验模型,以此动物模型,我们记录缺血前到缺血３０分钟缺血区域与正常区域的ＥＥＧ,分析了复杂度。我们发现,缺血引起ＥＥＧ复杂度明显的变化,在整个缺血实验过程中,缺血区域的ＥＥＧ复杂度小于正常区域,两个区域ＥＥＧ复杂度之间呈增大速率渐低的增长趋势;损伤发生时,损伤区域的ＥＥＧ复杂度小于正常值。用复杂度分析的结果与我们对同一实验的离散Ｇａｂｏｒ谱分析结果以及ＨＥ染色分析的热     

颈椎病患者经颅多普勒检查与头颅CT和脑电图的关系

应用多普勒技术对50例确诊为椎动脉型颈椎病的患者进行了检查,结果30例异常。其中25例主要表现为不同程度的双侧颈动脉血流量对称性偏低,管径及头颅CT无异常,脑电图部分改变,主要表现为低幅慢波,经治疗后症状改善,多普勒复查正常,说明CT正常不能否定脑缺性血管病的存在,CT不能代替多普勒检查,另5例主要表现为双侧颈动脉血流量不对称,其中3例为双侧血管经狭窄,CT提示全脑萎缩,脑电图呈低幅慢波;另2例CT提示左颞后顶区,右枕外侧区梗塞,脑电图及脑电地形图表现相应部位慢波灶达6～7级。CT异常者,临床治疗效果欠佳,多普勒检查和脑电图及临床症状变化不大,故多普勒检查对监测脑动力循环有一定意义。     

现行脑电图诊断标准是否适用于脑卒中?

79例脑内出血,按现通用之脑电图诊断标准,其异常率在发病15日内为93.3％,15日后为73.8％,两者相比,无显著差异(P>0.05)。然而,按阳性率两者各为86.6％与56.9％,两者阳性率有非常显著差异(P<0.01),因此,BEG的阳性标准适用于脑卒中病人。     

The value of EEG-Mapping in focal cerebral lesions

Summary In 148 patients with focal cerebral lesions the findings of EEG mapping, routine EEG and CT were compared. Regarding etiology 43 patients suffered from completed stroke (CS), 43 patients from transient ischemic attack (TIA), 33 patients had an intracerebral hemorrhage (ICH) and 29 an hemispheric tumor. In 37 patients with CS (86%) and 27 patients with TIA (63%) the EEG mapping revealed focal changes, but only in 28 patients with CS (65%) and in 11 patients (26%) with TIA using routine EEG alone. Thus the EEG mapping showed focal abnormalities significantly more often. In the remaining patient groups no significant difference in the results of EEG mapping or routine EEG could be demonstrated. Focal abnormalities corresponding to focal lesions seen in CT were obtained by means of EEG mapping in 27 patients (90%) with CS and 10 patients (77%) with TIA, but only in 17 patients (57%) with CS and 4 patients (31%) with TIA using routine EEG and in that way the EEG mapping could indicate focal lesions in CT significantly more often than routine EEG. In the remaining patient groups no significant difference in the number of focal changes corresponding to lesions in CT could be seen.     

麻醉剂浓度对大鼠暴发-抑制脑电特征的影响

暴发-抑制脑电图(EEG)是深度麻醉状态下EEG活动受到严重抑制的表现。为定量研究暴发-抑制波形特征与麻醉剂浓度之间的关系,本文采用暴发-抑制比、暴发频率、暴发幅度和抑制幅度4个时域指标,分析大鼠麻醉模型在不同异氟烷浓度下的EEG特征。结果表明,暴发-抑制脑电的4个指标均随异氟烷浓度的改变而变化:异氟烷浓度越大,暴发-抑制比和暴发幅度越大,暴发频率和抑制幅度越小。暴发-抑制比可快速反映异氟烷浓度的变化,且个体间一致性高,有潜力作为深度麻醉状态下暴发-抑制EEG较理想的特征指标。     

Protocol for electrophysiological monitoring of carotid endarterectomies

Near zero stroke rates can be achieved in carotid endarterectomy (CEA) surgery with selective shunting and electrophysiological neuromonitoring. though false negative rates as high as 40% have been reported. We sought to determine if improved training for interpretation of the monitoring signals can advance the efficacy of selective shunting with electrophysiological monitoring across multiple centers, and determine if other factors could contribute to the differences in reports. Processed and raw beta band (12.5-30 Hz) electroencephalogram (EEG) and median and tibial nerve somatosensory evoked potentials (SSEP) were monitored in 668 CEA cases at six surgical centers. A decrease in amplitude of 50% or more in any EEG or SSEP channel was the criteria for shunting or initiating a neuroprotective protocol. A reduction of 50% or greater in the beta band of the EEG or amplitude of the SSEP was observed in 150 cases. No patient showed signs of a cerebral infarct after surgery. Selective shunting based on EEG and SSEP monitoring can reduce CEA intraoperative stroke rate to a near zero level if trained personnel adopted standardized protocols. We also found that the rapid administration of a protective stroke protocol by attending anesthesiologists was an important aspect of this success rate.     

杂交手术治疗累及弓部的Stanford B型主动脉夹层的疗效分析

目的:探讨杂交手术在治疗累及弓部的Stanford B型主动脉夹层（TBAD）中的有效性和安全性。方法:前瞻性描述性研究。纳入2020年1月—2021年9月蚌埠医学院第一附属医院血管外科确诊为累及弓部的TBAD患者。其中男16例,女5例;年龄32~81（59.7±12.9）岁。患者均采用外科转流术和胸主动脉腔内修复术相...     

Electrophysiological measures of acute cerebral ischaemia

A method of EEG analysis is described which provides new insights into EEG pathology in cerebral ischaemia. The method is based on a variant of detrended fluctuation analysis (DFA), which reduces short (10 s) segments of spontaneous EEG time series to two dimensionless scaling exponents. The spatial variability of each exponent is expressed in terms of its statistical moments across EEG channels. Linear discriminant analysis combines the moments into concise indices, which distinguish normal and stroke groups remarkably well. On average over the scalp, stroke patients have larger fluctuations on the longest time scales. This is consistent with the notion of EEG slowing, but extends that notion to a wider range of time scales. The higher moments show that stroke patients have markedly reduced variability over the scalp. This contradicts the notion of a purely focal EEG scalp topography and argues instead for a highly distributed effect. In these indices, subacute patients appear further from normal than acute patients.     

脑血管病的脑电图、脑电地形图与TCD、CT的对比研究

对１７４例脑血管病患者脑电图、脑电地形图、ＴＣＤ和ＣＴ的资料进行对比研究。全部病人分为４组，即ＴＩＡ组、腔隙梗塞组、脑梗塞组及脑出血组。结果表明，ＣＴ检查ＴＩＡ组阳性率最低，仅３．３％。对ＥＥＧ，ＢＥＡＭ及ＴＣＤ三者检查结果进行比较，异常率依次为ＢＥＡＭ（８３％）＞ＴＣＤ（８０％）＞ＥＥＧ（５４％），ＢＥＡＭ对检测ＴＩＡ的意义最大。这些观察提示ＥＥＧ／ＢＥＡＭ对各类脑血管病的检测有着相对的特异性、敏感性及重要性，是实现脑血管病早期诊断的重要手段之一。     

周围性面神经炎急性期脑电图的改变与临床意义

目的：探讨周围性面神经炎急性期ＥＥＧ改变与临床意义。方法：对４６例周围性面神经炎急性期进行了ＥＥＧ检查,对其结果与临床的关系进行了研究。结果：４６例周围性面神经炎急性期ＥＥＧ异常１６例（３４．８％）,ＥＥＧ异常主要见于伴有面、舌部感觉异常的中、重型面瘫病例,异常程度主要是轻、中度异常,异常特点是以面竣对侧为主的低、中波幅θ活动。结论：周围性面神经炎中、重型急性中伴有脑电活动异常。     

功率谱熵在局灶性缺血性脑损伤无创检测中的应用

为了对局灶性缺血脑损伤的程度进行无创诊断，并对损伤区域进行定位，用SD(Sparague—dawley)实验大鼠建立了一个局灶性缺血脑损伤的动物实验模型，采得缺血前到缺血30min时的缺血区域与正常区域的EEG(Electroencephalogram)信号，并采用功率谱熵对EEG信号进行了分析。结果发现局灶性脑缺血导致EEG信号的功率谱熵发生了明显的变化。缺血侧的EEG信号的功率谱熵在缺血15min时已经明显低于缺血前的正常值，在整个缺血过程中缺血侧的EEG信号的功率谱熵小于正常区域的功率谱熵。这表明EEG信号的功率谱熵是一种很好的表征脑缺血损伤的参数，具有计算简便、有效的优点。     

18例复杂部分性癫痫发作患者同步录像脑电图监测报告

目的：探讨同步录像脑电图（Video-EEG）在复杂部分性癫痫发作诊断中的应用价值。方法：利用ZN8000型EEG仪对临床确诊的18例复杂部分性发作患者进行脑电和行为监测,监测时间2．5～28h平均用18.8h。结果：共监测到93次临床发作,睡眠中发作54次,清醒时发作39次,发作持续时间7～120s,平均34．8s。发作时的临床表现：双眼向前或向一侧凝视11例,头向一侧转动9例,一侧面部或肢体抽搐9例,行为或口咽自动症6例,精神症状5例,姿势性发作5例,对发作过程不能回忆15例。发作期EEG示癫病样放电（棘波、尖波、棘慢、尖慢综合波）12例,阵发性高幅慢波5例,未见异常1例,EEG异常率95％。发作间期EEG示中高幅阵发性慢波3例,阵发性痫样放电9例,未见异常6例,EEG异常率65％。结论：Video－EEG对复杂部分性癫痫发作有重要诊断价值,痫样放电与临床发作密切相关。     

脑血管病脑电图动态改变

目的：观察脑血管病发病后不同时期脑电图（ＥＥＧ）动脉改变，方法：对４００例脑血管病病人的在发病后３天内，３天－一周、３周以上进行连续ＥＥＧ检查。结果：脑出血、蛛网膜下腔箅和脑梗塞发病后３天内ＥＥＧ改变最明显。异常ＥＥＧ分别是９４．８％、８３．３５％和６４％，随着病程延长，３周后ＥＥＧ各项发迹均逐渐减轻，异常ＥＥＧ分别是３８％、１３％和３０％，结论：脑血管病ＥＥＧ的动态改变与脑血管病的病理改变和临床表现是一致的。     

缺血性脑卒中患者急性期的脑电图分析

目的:观察缺血性脑梗死患者的脑电图(EEG)表现,评价与其预后的关系。方法:对132 例经头颅CT证实的脑梗死患者进行EEG检查,分析其异常程度与脑梗死类型和临床预后的关系。结果:132例患者EEG正常者22例(16．7％),轻度异常者46例(34．8％),中度异常者50例(37．9％),重度异常者14(10．6％),总异常110例(83．3％);EEG正常或轻度异常主要见于腔隙性脑梗死患者,EEG 重度异常主要见于大面积脑梗死患者;EEG异常程度越重,预后越差。结论:EEG可反映脑梗死患者的脑功能状态,其异常程度有助于判断患者预后。     

伴中央—颞棘波灶的儿童良性癫痫

目的探讨伴中央—颞棘波灶的儿童良性癫痫的临床和脑电图（ＥＥＧ）特点。方法对１９８６年以来确诊的２４６例患儿的临床和ＥＥＧ资料进行回顾性分析。结果发现所有患儿发作间期都有特征性的ＥＥＧ改变，即在正常的背景活动基础上，中央一中颞区出现成串或单一的高波幅的棘波。这种改变可局限于一侧半球，也可从一侧半球转移至对侧半球或双侧半球。患儿临床上伴面部、半身或全身的强直－阵挛性抽搐。年龄超过１５岁后癫痫发作几乎全部停止。结论ＥＥＧ是诊断本症的根本依据。     

局灶性缺血脑损伤EEG信号的复杂度研究

建立了一个局灶性缺血脑损伤实验模型,记录缺血前到缺血３０分钟缺血区域与正常区域的ＥＥＧ,分析了其复杂度。发现缺血引起ＥＥＧ复杂度发生明显的变化,在整个缺血实验过程中,缺血区域的ＥＥＧ复杂度小于正常区域,两个区域ＥＥＧ复杂度之差呈增大速率渐低的增长趋势,     

Evolution of sleep and sleep EEG after hemispheric stroke

The evolution of subjective sleep and sleep electroencephalogram (EEG) after hemispheric stroke have been rarely studied and the relationship of sleep variables to stroke outcome is essentially unknown. We studied 27 patients with first hemispheric ischaemic stroke and no sleep apnoea in the acute (1-8 days), subacute (9-35 days), and chronic phase (5-24 months) after stroke. Clinical assessment included estimated sleep time per 24 h (EST) and Epworth sleepiness score (ESS) before stroke, as well as EST, ESS and clinical outcome after stroke. Sleep EEG data from stroke patients were compared with data from 11 hospitalized controls and published norms. Changes in EST (>2 h, 38% of patients) and ESS (>3 points, 26%) were frequent but correlated poorly with sleep EEG changes. In the chronic phase no significant differences in sleep EEG between controls and patients were found. High sleep efficiency and low wakefulness after sleep onset in the acute phase were associated with a good long-term outcome. These two sleep EEG variables improved significantly from the acute to the subacute and chronic phase. In conclusion, hemispheric strokes can cause insomnia, hypersomnia or changes in sleep needs but only rarely persisting sleep EEG abnormalities. High sleep EEG continuity in the acute phase of stroke heralds a good clinical outcome.     

术中颅内电极脑电监测在联合术式治疗顽固性癫痫中的应用

目的：探讨术中颅内电极脑电监测在癫痫外科手术中的应用方法及价值。方法：回顾分析难治性癫痫患者78例术中采用颅内电极脑电监测,在病灶切除前对致痫灶区行皮层电极描记,记录有无痼样放电和范围,对痫灶部位进一步精确定位。采用联合手术方法进行病灶切除,之后再次或多次描记,以判断痼样放电有无减少或消失,对有痫样放电的皮层再次进行软膜下横切术。术后常规应用抗癫痫药物。结果：78例患者,术前均在预定的致痫灶局部记录到棘波、棘慢波、尖波和尖慢波;致痢灶切除后即时监测结果显示其中有7例痫样放电完全消失,56例痫样放电明显减少、背景波幅降低,15例在病灶周围仍散在有明显痫样放电,经再次处理后减少,所有患者均无神经功能损害加重。78例患者均随访6个月至4年,多数患者生活质量提高、精神状态改善。其中发作消失51例（65％）,发作明显减少（75％以上）16例（21％）,发作减少（50％以上）7例（9％）,发作无变化4例（5％）。总有效率为95％。结论：在癫痫外科手术中运用颅内电极进行脑电监测,能进一步明确致痂灶部位、监测异常波出现的范围及异常程度,指导手术中正确切除致痫灶,在癫痫外科治疗中具有一定的实用价值。     

Correlation of EEG activities between slow-wave sleep and wakefulness in patients with supra-tentorial stroke

Summary Using topographic EEG mapping, we studied the relationships between delta activity during slow-wave sleep (SWS) and the background EEG activity during wakefulness, in 11 normal subjects and 35 stroke patients with unilateral supra-tentorial lesions. Delta-1 power during SWS showed a significant positive correlation with alpha-1 power during wakefulness, in both hemispheres. Delta-1 and delta-2 power during SWS correlated positively not only with alpha-2 power, but also with delta-1 and delta-2 power during wakefulness in the affected hemisphere. These figures indicate that the amount of delta activity during SWS can be associated with that of alpha activity during wakefulness. A close negative correlation was observed between delta power during SWS and the age of the subjects in the patient group. The Barthel index showed no significant correlation with delta-1 or delta-2 power in either hemisphere in patient group. Our results suggest that delta activity during SWS may be associated with dysfunction of the cerebral cortex in stroke patients as well as in normal aged subjects.     

脑梗死患者的脑电图变化与有关因素——阳性诊断标准研究

目的：探讨脑梗死患者脑电图（ＥＥＧ）改变与有关因素的关系。方法：用ＥＥＧ阳性诊断标准对２３７例脑梗死（ＣＩ）和１４７例腔隙梗死（ＬＩ）患者的脑波进行分析,结果：ＣＩ组在发病４周内ＥＥＧ阳性率显著高于１月后（Ｐ＜００１）,而ＬＩ组则无统计学意义（Ｐ＞００５）。ＣＩ组阳性率（６５％）显著高于ＬＩ组（２１８％,Ｐ＜００１）。ＥＥＧ阳性与病初意识障碍或精神症状有关,然而ＥＥＧ阳性率与病变部位或瘫痪程度有关仅见于ＣＩ组。结论：阳性诊断标准能反映卒中后ＥＥＧ变化特征。