Monitoring Pressure Augmentation in Patients With Ischemic Penumbra Using Continuous Electroencephalogram: Three Cases and a Review of the Literature

Overview

Journal Neurohospitalist

Publisher Sage Publications

Date 2017 Oct 5

PMID 28974996

Citations 1

Authors

Christopher R Newey

Vikas Gupta

Agnieszka A Ardelt

Affiliations

Soon will be listed here.

Abstract

Background: Continuous electroencephalography (CEEG) is a sensitive, noninvasive surrogate monitor of cerebral blood flow (CBF). Changes in CBF can be seen as changes in the frequencies on the CEEG. This case series suggests that increase in CEEG frequencies may be used to detect improved CBF following pressure augmentation such as with treatment of vasospasm from subarachnoid hemorrhage (SAH) or acute thrombosis from ischemic stroke. The application of this observation to clinical decision-making has not been clearly defined and requires further study.

Methods: Case series and imaging.

Results: We present 3 patients with ischemic penumbras either from vasospasm from SAH or thrombosis from acute ischemic stroke. All patients were monitored on CEEG and found to have lateralized slowing. During pressure augmentation, the lateralized slowing improved in frequency, which corresponded with improvement in the patients' neurological examinations.

Conclusion: Continuous electroencephalography may be used as a noninvasive monitor to allow for individualization of pressure augmentation in cases of vasospasm from SAH or in cases of acute ischemic strokes. This customized approach may allow for less morbidity associated with pressure augmentation in patients who otherwise may have dysfunction of their intracerebral autoregulation.

Citing Articles

Early detection of brainstem herniation using electroencephalography monitoring - case report.

Mullaguri N, Beary J, Newey C BMC Neurol. 2020; 20(1):406.

PMID: 33158418 PMC: 7647882. DOI: 10.1186/s12883-020-01988-7.

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