NEUROMONITORING IN PATIENTS WITH INTRACRANIAL NONTRAUMATIC HEMORRHAGE
Background: Investigation of patients with intracranial non-traumatic hemorrhage (INH) with the use of prolonged electroencephalographic (EEG) monitoring allows for more effective identification of acute symptomatic seizures, subclinic epileptiform activity, local and diffuse abnormalities that are...
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| Format: | Article |
| Language: | Russian |
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MONIKI
2016-02-01
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| Series: | Alʹmanah Kliničeskoj Mediciny |
| Subjects: | |
| Online Access: | https://www.almclinmed.ru/jour/article/view/209 |
| _version_ | 1818886785062666240 |
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| author | M. A. Alakova A. S. Kotov A. M. Kiselev M. V. Romanova |
| author_facet | M. A. Alakova A. S. Kotov A. M. Kiselev M. V. Romanova |
| author_sort | M. A. Alakova |
| collection | DOAJ |
| description | Background: Investigation of patients with intracranial non-traumatic hemorrhage (INH) with the use of prolonged electroencephalographic (EEG) monitoring allows for more effective identification of acute symptomatic seizures, subclinic epileptiform activity, local and diffuse abnormalities that are markers of brain functional activity.Aim: To increase treatment efficacy of patients with INH.Materials and methods: Thirty three patients were assessed in acute period of INH. Assessments included clinical and neurological examination, NIHSS (National Institute of Health Stroke Severity scale), GCS (Glasgow coma scale), HHS (Hunt-Hess scale); prolonged EEG monitoring with computerized tomography and/or magnetic resonance imaging of the brain. Patients received medical and surgical treatment (minimally invasive endovascular interventions or open operations, such as aneurysm clipping or wrapping/coating).Results: Twenty seven patients had open-type surgeries (among them, 23 patients had aneurysm clipping and 4, aneurysm wrapping). Two patients underwent the procedure of aneurysm embolization. Four patients were treated conservatively. According to results of prolonged pre-, peri- and postoperative EEG monitoring, most of patients had signs of disorganized electrical activity, with no regional differences, fragmented or absent alfa rhythm and diffuse polymorphic theta-activity. Marked EEG abnormalities correlated with severity registered with the assessment scales and with outcomes. During the study, epileptiform activity was registered in 1 patient, EEG comate in 3, diffuse abnormalities in 15 and local abnormalities in 14.Conclusion: The use of prolonged pre-, peri- and postoperative EEG monitoring allows for timely identification of status epilepticus, including the one without seizures. Minimally invasive interventions performed on time are associated with better prognosis in INH patients, whereas marked EEG abnormalities are associated with low scores of the assessment scales and adverse outcomes. In conscious patients with local brain lesions EEG does not have any significant value for topical diagnostics. |
| first_indexed | 2024-12-19T16:26:51Z |
| format | Article |
| id | doaj.art-87925ceda2ec416b9a705db3a2758ccb |
| institution | Directory Open Access Journal |
| issn | 2072-0505 2587-9294 |
| language | Russian |
| last_indexed | 2024-12-19T16:26:51Z |
| publishDate | 2016-02-01 |
| publisher | MONIKI |
| record_format | Article |
| series | Alʹmanah Kliničeskoj Mediciny |
| spelling | doaj.art-87925ceda2ec416b9a705db3a2758ccb2022-12-21T20:14:18ZrusMONIKIAlʹmanah Kliničeskoj Mediciny2072-05052587-92942016-02-01039222810.18786/2072-0505-2015-39-22-28209NEUROMONITORING IN PATIENTS WITH INTRACRANIAL NONTRAUMATIC HEMORRHAGEM. A. Alakova0A. S. Kotov1A. M. Kiselev2M. V. Romanova3Moscow Regional Research and Clinical Institute (MONIKI)Moscow Regional Research and Clinical Institute (MONIKI)Moscow Regional Research and Clinical Institute (MONIKI)Moscow Regional Research and Clinical Institute (MONIKI)Background: Investigation of patients with intracranial non-traumatic hemorrhage (INH) with the use of prolonged electroencephalographic (EEG) monitoring allows for more effective identification of acute symptomatic seizures, subclinic epileptiform activity, local and diffuse abnormalities that are markers of brain functional activity.Aim: To increase treatment efficacy of patients with INH.Materials and methods: Thirty three patients were assessed in acute period of INH. Assessments included clinical and neurological examination, NIHSS (National Institute of Health Stroke Severity scale), GCS (Glasgow coma scale), HHS (Hunt-Hess scale); prolonged EEG monitoring with computerized tomography and/or magnetic resonance imaging of the brain. Patients received medical and surgical treatment (minimally invasive endovascular interventions or open operations, such as aneurysm clipping or wrapping/coating).Results: Twenty seven patients had open-type surgeries (among them, 23 patients had aneurysm clipping and 4, aneurysm wrapping). Two patients underwent the procedure of aneurysm embolization. Four patients were treated conservatively. According to results of prolonged pre-, peri- and postoperative EEG monitoring, most of patients had signs of disorganized electrical activity, with no regional differences, fragmented or absent alfa rhythm and diffuse polymorphic theta-activity. Marked EEG abnormalities correlated with severity registered with the assessment scales and with outcomes. During the study, epileptiform activity was registered in 1 patient, EEG comate in 3, diffuse abnormalities in 15 and local abnormalities in 14.Conclusion: The use of prolonged pre-, peri- and postoperative EEG monitoring allows for timely identification of status epilepticus, including the one without seizures. Minimally invasive interventions performed on time are associated with better prognosis in INH patients, whereas marked EEG abnormalities are associated with low scores of the assessment scales and adverse outcomes. In conscious patients with local brain lesions EEG does not have any significant value for topical diagnostics.https://www.almclinmed.ru/jour/article/view/209nontraumatic intracranial hemorrhageepilepsystatus epilepticuseeg monitoringsurgery intracranial hemorrhage |
| spellingShingle | M. A. Alakova A. S. Kotov A. M. Kiselev M. V. Romanova NEUROMONITORING IN PATIENTS WITH INTRACRANIAL NONTRAUMATIC HEMORRHAGE Alʹmanah Kliničeskoj Mediciny nontraumatic intracranial hemorrhage epilepsy status epilepticus eeg monitoring surgery intracranial hemorrhage |
| title | NEUROMONITORING IN PATIENTS WITH INTRACRANIAL NONTRAUMATIC HEMORRHAGE |
| title_full | NEUROMONITORING IN PATIENTS WITH INTRACRANIAL NONTRAUMATIC HEMORRHAGE |
| title_fullStr | NEUROMONITORING IN PATIENTS WITH INTRACRANIAL NONTRAUMATIC HEMORRHAGE |
| title_full_unstemmed | NEUROMONITORING IN PATIENTS WITH INTRACRANIAL NONTRAUMATIC HEMORRHAGE |
| title_short | NEUROMONITORING IN PATIENTS WITH INTRACRANIAL NONTRAUMATIC HEMORRHAGE |
| title_sort | neuromonitoring in patients with intracranial nontraumatic hemorrhage |
| topic | nontraumatic intracranial hemorrhage epilepsy status epilepticus eeg monitoring surgery intracranial hemorrhage |
| url | https://www.almclinmed.ru/jour/article/view/209 |
| work_keys_str_mv | AT maalakova neuromonitoringinpatientswithintracranialnontraumatichemorrhage AT askotov neuromonitoringinpatientswithintracranialnontraumatichemorrhage AT amkiselev neuromonitoringinpatientswithintracranialnontraumatichemorrhage AT mvromanova neuromonitoringinpatientswithintracranialnontraumatichemorrhage |