Prediction of malignant course in large midge cerebral artery infarction by electroencephalography

Abstract

Objective To explore the predictive value of early electroenphalography （EEG） for a malignant course in patients with large middle cerebral artery infarction （LMCAI）. Methods Thirty-seven patients （20 patients with a malignant and 17 with a benign course） with stroke of 〉50% of the middle cerebral artery territory in early CT/MRI scan were included; Glasgow-Pittsberg Coma Scale （24±7 vs. 30±4, P =0. 003） and National Institutes of Health Stroke Scale （23 ±3 vs. 16 ±4, P =0. 000） in the group with a malign course were higher than those in the group with a benign course. Early EEG was recorded within 24 h after ischemic stroke. The correlation between the change characteristics of EEG and a malignant course in patients with LMCAI was analyzed. Results The contralateral occipital background frequencies 〈 8 Hz （17/20 vs. 3/20, P =0.000）, β frequency within the focus ≤20 Hz （19/26 vs. 7/26, P=0.001）, EEG non-reaction to stimuli （11/12 vs. 1/12, P=0.002）, slowing affecting the whole hemisphere in the lesion （17/24 vs. 7/24, P=0. 008） and focal slowing contralateral to the lesion （16/19 vs. 3/19, P =0. 000） were significantly related with a malignant course. Whereas the contralateral occipital background frequencies ≥ 8 Hz （14/17 vs. 3/17, P =0. 000）, β frequency 〉20 Hz within the focus （10/11 vs. 1/11, P =0.001） were related with a benign course. Conclusions Early EEG has a certain predictive value for a malignant course in patients with LMCAI, and it may be used as one of the bedside monitoring approaches of LMCAI. Key words: Brain infarction; Infarction, middle cerebral artery; Electroencephalography; Disease progression