Abstract
BackgroundContinuous electroencephalogram (EEG) monitoring is useful for assessing the level of sedation and detecting non-convulsive epileptic seizures and cerebral ischemia in the intensive care unit. This report describes a case of cerebral hemorrhagic infarction diagnosed after the detection of high-amplitude slow waves on processed EEG during sedation.Case presentationA 68-year-old man who underwent cardiac surgery was sedated in the intensive care unit following an invasive procedure. High-amplitude slow waves appeared on processed EEG monitoring before the detection of anisocoria. Computed tomography revealed a cerebral hemorrhagic infarction.ConclusionsIn the management of critically ill patients, continuous EEG monitoring with forehead electrodes may be useful in the early detection of brain lesions.
Highlights
BackgroundProcessed electroencephalogram (EEG) monitoring has been used and recommended for the assessment of the depth of anesthesia during surgery [1, 2]
Continuous electroencephalogram (EEG) monitoring is useful for assessing the level of sedation and detecting non-convulsive epileptic seizures and cerebral ischemia in the intensive care unit
In the management of critically ill patients, continuous EEG monitoring with forehead electrodes may be useful in the early detection of brain lesions
Summary
Processed electroencephalogram (EEG) monitoring has been used and recommended for the assessment of the depth of anesthesia during surgery [1, 2]. Processed EEG monitoring is used to assess the depth of sedation in cases managed with artificial ventilation in our hospital. We report the case of a patient with postoperative cerebral hemorrhagic infarction, where slow waves were detected during processed EEG monitoring before the appearance of pupillary dilatation. The patient was sedated with propofol and dexmedetomidine, and the sedation was assessed by monitoring the EEG with four electrodes placed bilaterally on the forehead and processed by Sedline® (Masimo Corporation, CA, USA). 2 mm) was detected at 5 a.m. on POD 8, and the pupils were bilaterally dilated to 6 mm at 10 a.m. on the same day His GCS score was 3 (E1, VT, M1), and raw EEG on SedLine® revealed slow waves, while the PSI values ranged between 20 and 25 at that time. The patient was confirmed to have died on POD 8
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