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Monitoring of patients with brainstem hemorrhage: A simultaneous study of quantitative electroencephalography and transcranial Doppler
Institution:Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin 130021, China
Abstract:ObjectiveTo explore whether quantitative electroencephalography (QEEG) and transcranial Doppler (TCD) can be used to evaluate patients with acute severe brainstem hemorrhage (ASBH).MethodsWe prospectively enrolled patients with ASBH and assessed their mortality at the 90-day follow-up. The patients' demographic data, serological data, and clinical factors were recorded. Quantitative brain function monitoring was performed using a TCD-QEEG recording system attached to the patient’s bedside.ResultsThirty-one patients (55.3 ± 10.6 years; 17 men) were studied. Mortality at 90 days was at 61.3%. There was no significant difference in TCD-related parameters between the survival group and the death group (p > 0.05). Among the QEEG-related indexes, only the (delta + theta)/(alpha + beta) ratio (DTABR) (odds ratio 11.555, 95%confidence interval 1.413–94.503, p = 0.022) was an independent predictor of clinical outcome; the area under the ROC curve of DTABR was 0.921, cut-off point was 3.88, sensitivity was 79%, and specificity was 100%.ConclusionsIn patients with ASBH, QEEG can effectively inform the clinical prognosis regarding 90-day mortality, while TCD cannot.SignificanceQEEG shows promise for informing the mortality prognosis of patients with ASBH.
Keywords:Electroencephalography  Transcranial Doppler  Brain stem hemorrhage  Neurophysiological monitoring  Prognosis  QEEG"}  {"#name":"keyword"  "$":{"id":"k0035"}  "$$":[{"#name":"text"  "_":"quantitative electroencephalography  TCD"}  {"#name":"keyword"  "$":{"id":"k0045"}  "$$":[{"#name":"text"  "_":"Transcranial Doppler  BH"}  {"#name":"keyword"  "$":{"id":"k0055"}  "$$":[{"#name":"text"  "_":"brainstem hemorrhage  ASBH"}  {"#name":"keyword"  "$":{"id":"k0065"}  "$$":[{"#name":"text"  "_":"acute severe brainstem hemorrhage  CBF"}  {"#name":"keyword"  "$":{"id":"k0075"}  "$$":[{"#name":"text"  "_":"Cerebral blood flow  ICH"}  {"#name":"keyword"  "$":{"id":"k0085"}  "$$":[{"#name":"text"  "_":"Intracerebral hemorrhage  INR"}  {"#name":"keyword"  "$":{"id":"k0095"}  "$$":[{"#name":"text"  "_":"International Normalized Ratio  GCS"}  {"#name":"keyword"  "$":{"id":"k0105"}  "$$":[{"#name":"text"  "_":"Glasgow Coma Scale  PI"}  {"#name":"keyword"  "$":{"id":"k0115"}  "$$":[{"#name":"text"  "_":"Pulsatility index  BSI"}  {"#name":"keyword"  "$":{"id":"k0125"}  "$$":[{"#name":"text"  "_":"Brain symmetry index  DAR"}  {"#name":"keyword"  "$":{"id":"k0135"}  "$$":[{"#name":"text"  "_":"Delta/alpha ratio  DTABR"}  {"#name":"keyword"  "$":{"id":"k0145"}  "$$":[{"#name":"text"  "_":"(Delta + theta)/(alpha + beta)ratio  RAP"}  {"#name":"keyword"  "$":{"id":"k0155"}  "$$":[{"#name":"text"  "_":"Relative alpha power  RBP"}  {"#name":"keyword"  "$":{"id":"k0165"}  "$$":[{"#name":"text"  "_":"Relative beta power  RDP"}  {"#name":"keyword"  "$":{"id":"k0175"}  "$$":[{"#name":"text"  "_":"Relative delta power  RTP"}  {"#name":"keyword"  "$":{"id":"k0185"}  "$$":[{"#name":"text"  "_":"Relative theta power
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