Value of EEG reactivity and midbrain morphology in prognosis of coma patients with severe traumatic brain injury

Abstract

Objective To investigate the relationship between electroencephalogram (EEG) reactivity combined with midbrain morphology and clinical outcomes of coma patients with severe head injury.Methods One hundred and sixteen coma patients with acute severe brain injury,admitted to our hospital from April 2011 to October 2012,were chosen in our study; EEG reactivity of the patients was monitored by digitized EEG monitoring system within 72 hours of admission,and the ratio of anteroposterior diameter and transverse diameter in the midbrain was measured under brain CT scan.The relations of EEG reactivity and ratio of anteroposterior diameter and transverse diameter with prognosis of these patients were statistically analyzed.Results Of the 116 patients,EEG reactivity examination showed response in 65 patients,including 57 patients with good prognosis; and the other 51 patients ECG reactivity showed no reaction,just 10 having good prognosis; the good prognosis rate in patients with positive EGG reactivity was significantly higher than that in patients with negative EGG reactivity (P＜0.05).According to the ratio of anteroposterior diameter and transverse diameter in the midbrain,60 patients had a ratio of 0.9 to 1.1,including 48 having good prognosis,and 56 patients had a ratio of＞1.1or＜0.9,just 19 having good prognosis; the difference was statistically significant (P＜0.05).The sensitivity and specificity in EEG reactivity combined with midbrain morphology in evaluating the prognosis of coma patients with severe traumatic brain injury were higher.Conclusion EEG reactivity combined with midbrain morphology can effectively assess the prognosis of coma patients with severe traumatic brain injury. Key words: EEG reactivity; CT scan; Severe traumatic brain injury; Prognosis