脑电图在预测急性前循环梗死血管内治疗患者预后中的应用

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-05-13 DOI:10.1016/j.jocn.2025.111252

Yuting Yang , Li Peng , Ying Li , Miaoxia Wang , Wensheng Zhou , Zhiwen Zhou

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引用次数: 0

摘要

目的探讨脑电图（EEG）监测在急性前循环卒中血管内治疗（EVT）患者预后评价中的应用。方法：本研究是一项回顾性研究，纳入了急性前循环大血管闭塞（LVO）患者，这些患者在严格的影像学评估后确定有手术指征，并在发病后24小时内接受了治疗。所有入组患者均在局麻下行血管内治疗（EVT），术后均迅速达到mTICI（改良脑缺血治疗）评分3分。记录患者性别、年龄、发病至再灌注时间、TOAST分型、血管闭塞部位、术前NIHSS评分、术后第1、3、7天脑电图及3个月mRS评分。术后24小时、3天、7天的脑电图结果不同，患者预后不同，差异有统计学意义(P <；0.001)。24 h脑电图能准确预测急性前循环卒中血管内治疗患者的预后（AUC = 0.811）， 7 d脑电图准确率最高（AUC = 0.955）。第3天和第7天的脑电图结果对预测预后的敏感性最高，敏感性均为100%。治疗后24 h ~ 3 d脑血管再灌注时间与脑电图改善率有相关性，差异有统计学意义。(P & lt;0.05)。3。术前NIHSS评分与术后24 h ~ 3 d脑电图改善率之间存在相关性，差异有统计学意义(P <；0.05)。4。TOAST分类与1周内脑电变化无明显相关性(P >；0.05)。5。急性前循环卒中血管内治疗患者的预后与术前NIHSS评分及发病至血管再灌注时间相关，差异有统计学意义(P <；0.05)，但与患者性别、年龄、闭塞部位或TOAST分类无关(P >；0.05)。结论seeg为评价急性前循环梗死患者血管内治疗后的预后提供了一种新的方法。

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The use of EEG in predicting the prognosis of patients undergoing endovascular treatment for acute anterior circulation infarction

Objective

This study aims to investigate the application of electroencephalogram (EEG) monitoring in evaluating the prognosis for patients undergoing endovascular treatment (EVT) for acute anterior circulation stroke.

Methods

This is a retrospective study that includes patients with acute large-vessel occlusion (LVO) of the anterior circulation who were identified as having surgical indications after rigorous imaging evaluations and have treated within 24 h since onset. All enrolled patients went through endovascular treatment (EVT) under local anesthesia, and all achieved a mTICI (the modified Treatment In Cerebral Ischemia) score of 3 promptly after the procedure. The recorded data includes like the gender, age, time from onset to reperfusion, TOAST classification, location of vessel occlusion, preoperative NIHSS scores, EEG readings at day 1, 3 and 7 after the procedure, and mRS scores at 3 months.

Results

1. The patients’ prognoses differed based on diverse findings on the EEG taken at 24 h, 3 days, and 7 days after the procedure, and the difference was statistically significant (P < 0.001). While the 24 h EEG was capable to make an accurate prediction about the prognosis in patients undergoing endovascular treatment for acute anterior circulation stroke (AUC = 0.811), the one taken at 7 days presented the highest accuracy (AUC = 0.955). The EEG results collected at 3 days and 7 days shows the highest sensitivity in predicting the prognosis, both with a sensitivity of 100 %.

2. There was a correlation between the time to vessel reperfusion and the EEG improvement rate from 24 h to 3 days after treatment, and the difference statistically makes sense. (P < 0.05).

3. There was a link between the preoperative NIHSS scores and the rate of EEG improvement from 24 h to 3 days after the procedure, and the difference was statistically significant (P < 0.05).

4. No obvious correlation was detected between TOAST classification and EEG changes within one week (P > 0.05).

5. The prognosis in patients experiencing an endovascular therapy for acute anterior circulation stroke was related to the preoperative NIHSS scores and time from onset to vessel reperfusion, the difference being statistically significant (P < 0.05), but not with patient gender, age, occlusion site, or TOAST classification (P > 0.05).

Conclusions

EEG provides a new way to evaluate the prognosis of patients with acute anterior circulation infarction after endovascular treatment.

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.