My Editor’s Choice

Professor Ulf Ziemann,Editor-in-Chief, Clinical Neurophysiology

Professor Ulf Ziemann
Editor-in-Chief, Clinical Neurophysiology

The Editor’s Choice—

Alpha power decrease in quantitative EEG detects development of cerebral infarction after subarachnoid hemorrhage early

Clinical Neurophysiology Volume 132, Issue 6 (June 2021)

Mueller TM, Gollwitzer S, Hopfengärtner R, Rampp S, Lang JD, Stritzelberger J, Madzar D, Reindl C, Sprügel MI, Onugoren MD, Muehlen I, Kuramatsu JB, Schwab S, Huttner HB, Hamer HM (2021) Alpha power decrease in quantitative EEG detects development of cerebral infarction after subarachnoid hemorrhage early. Clinical Neurophysiology 132: 1283-1289

Delayed cerebral ischemia (DCI) is a major cause for persisting neurological deficits and poor outcome after subarachnoid hemorrhage (SAH). In clinical practice, vasospasm is routinely detected and monitored by transcranial Doppler sonography/transcranial color-coded duplex sonography (TCD/TCCS) or angiography to identify patients at risk of DCI. However, these techniques are not designed for continuous monitoring, and DCI can also develop without detection of relevant vasospasm, e.g., due to cortical spreading depression or microcirculatory dysfunction. Therefore, quantitative EEG (qEEG) may be used to detect deterioration of neuronal function due to reduced perfusion regardless of the underlying cause. Mueller et al. in this issue of Clinical Neurophysiology analyzed retrospectively 34 patients with SAH, of whom 9 developed DCI with continuous qEEG and TCD/TCCS. Patients with and without DCI significantly differed in qEEG parameters, such as maximum alpha power decrease, and summed hours of alpha power decrease, but showed no significant differences in TCD/TCCS parameters. Changes in qEEG parameters were observed earlier than changes in TCD/TCCS. Findings signify that qEEG represents a non-invasive, continuous tool to identify SAH patients at risk of cerebral infarction. This warrants further clinical trials to provide prospective evidence in larger clinical cohorts.

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