AI Article Synopsis
- - The study investigates the relationship between alpha power reduction in quantitative EEG and long-term outcomes in patients with subarachnoid hemorrhage, discovering that a significant decrease (≥40% for ≥5 hours) in alpha power is linked to a higher risk of poor recovery.
- - Out of 22 adult patients monitored, those with critical EEG events showed a 69% rate of poor outcomes, while all patients without such events achieved good recovery, indicating that alpha power is a strong predictor of patient prognosis.
- - The research concludes that stable alpha power suggests successful treatment and a favorable outcome, while critical reductions in alpha power signal a heightened risk for poor functional recovery following subarachnoid hemorrhage.
Article Abstract
Purpose: Delayed cerebral ischemia is a major complication after subarachnoid hemorrhage. Our previous study showed that alpha power reduction in continuous quantitative EEG predicts delayed cerebral ischemia. In this prospective cohort, we aimed to determine the prognostic value of alpha power in quantitative EEG for the long-term outcome of patients with subarachnoid hemorrhage.
Methods: Adult patients with nontraumatic subarachnoid hemorrhage were included if admitted early enough for EEG to start within 72 hours after symptom onset. Continuous six-channel EEG was applied. Unselected EEG signals underwent automated artifact rejection, power spectral analysis, and detrending. Alpha power decline of ≥40% for ≥5 hours was defined as critical EEG event based on previous findings. Six-month outcome was obtained using the modified Rankin scale.
Results: Twenty-two patients were included (14 male; mean age, 59 years; Hunt and Hess grade I-IV; duration of EEG monitoring, median 14 days). Poor outcome (modified Rankin scale, 2-5) was noted in 11 of 16 patients (69%) with critical EEG events. All six patients (100%) without EEG events achieved an excellent outcome (modified Rankin scale 0, 1) (P = 0.0062; sensitivity 100%, specificity 54.5%). Vasospasm detected with transcranial Doppler/Duplex sonography appeared 1.5 days after EEG events and showed weaker association with outcome (P = 0.035; sensitivity 100%, specificity 45.5%). There was no significant association between EEG events and ischemic lesions on imaging (P = 0.1). Also, no association between ischemic lesions and outcome was seen (P = 0.64).
Conclusions: Stable alpha power in quantitative EEG reflects successful therapy and predicts good functional outcome after subarachnoid hemorrhage. Critical alpha power reduction indicates an increased risk of poor functional outcome.
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