Transcranial Doppler combined with quantitative EEG brain function monitoring and outcome prediction in patients with severe acute intracerebral hemorrhage

Background: The etiology of remote DWI lesions in acute intracerebral hemorrhage (ICH) is still unknown. Postulated mechanisms include intracranial or extracranial emboli, small vessel abnormalities and ischemia following acute intracranial hypertension. Our aim is to evaluate the presence of spontaneous microembolic signals (MES) using transcranial Doppler (TCD) in acute ICH patients. Methods: Twenty patients with acute ICH were prospectively enrolled and monitored with TCD for 1 hour on admission days 1, 3 and 7. TCD monitoring was performed using 2MHz probes. Results: Of the 20 patients evaluated, 40% were females and mean age was 55.6±14.1. Eight patients (40%) had dyslipidemia, 15 (75%) hypertension, 5 (20%) diabetes, 2 (10%) ethanol abuse, 6 (30%) smoking and 1 (10%) had prior ischemic stroke. Most frequent location was lobar (9 patients). The mean hematoma volume was 13,5±17,9 ml. Of six patients who underwent MRI, 2 (20%) had remote DWI lesions. Embolic sources were found in 3 patients (1 with atrial fibrillation and 2 with large artery atherosclerosis). Microembolic signals were detected in seven patients (35%). Conclusion: The high occurrence of microemboli in patients admitted with acute ICH indicates a possible embolic mechanism for DWI lesions in these patients.

Download Full-text

Serum myeloperoxidase concentrations for outcome prediction in acute intracerebral hemorrhage

Clinica Chimica Acta ◽

10.1016/j.cca.2018.10.026 ◽

2018 ◽

Vol 487 ◽

pp. 330-336 ◽

Cited By ~ 4

Author(s):

Guan-Rong Zheng ◽

Bin Chen ◽

Jia Shen ◽

Shen-Zhong Qiu ◽

Huai-Ming Yin ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Outcome Prediction ◽

Acute Intracerebral Hemorrhage

Download Full-text

Transcranial Doppler Combined With Quantitative Electroencephalography Brain Function Monitoring for Estimating the Prognosis of Patients With Posterior Circulation Cerebral Infarction

Frontiers in Neurology ◽

10.3389/fneur.2021.600985 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yanting Cao ◽

Xiaonan Song ◽

Lijuan Wang ◽

Yajie Qi ◽

Ying Chen ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Cerebral Infarction ◽

Roc Curve ◽

Transcranial Doppler ◽

Brain Function ◽

Predictive Accuracy ◽

Posterior Circulation ◽

Quantitative Electroencephalography ◽

Brain Function Monitoring

Posterior circulation cerebral infarction (PCCI) can lead to deceased infratentorial cerebral blood flow (CBF) and metabolism. Neural activity is closely related to regional cerebral blood flow both spatially and temporally. Transcranial Doppler (TCD) combined with quantitative electroencephalography (QEEG) is a technique that evaluates neurovascular coupling and involves synergy between the metabolic and vascular systems. This study aimed to monitor brain function using TCD-QEEG and estimate the efficacy of TCD-QEEG for predicting the prognosis of patients with PCCI. We used a TCD-QEEG recording system to perform quantitative brain function monitoring; we recorded the related clinical variables simultaneously. The data were analyzed using a Cox proportional hazards regression model. Receiver-operating characteristic (ROC) curve analysis was used to evaluate the cut-off for the diastolic flow velocity (VD) and (delta + theta)/(alpha + beta) ratio (DTABR). The area under the ROC curve (AUROC) was calculated to assess the predictive validity of the study variables. Forty patients (aged 63.7 ± 9.9 years; 30 men) were assessed. Mortality at 90 days was 40%. The TCD indicators of VD [hazard ratio (HR) 0.168, confidence interval (CI) 0.047–0.597, p = 0.006] and QEEG indicators of DTABR (HR 12.527, CI 1.637–95.846, p = 0.015) were the independent predictors of the clinical outcomes. The AUROC after combination of VD and DTABR was 0.896 and showed better predictive accuracy than the Glasgow Coma Scale score (0.75), VD (0.76), and DTABR (0.781; all p < 0.05). TCD-QEEG provides a good understanding of the coupling mechanisms in the brain and can improve our ability to predict the prognosis of patients with PCCI.

Download Full-text

Effect on Middle Cerebral Artery Blood Flow of Nicardipine Hydrochloride of Acute Intracerebral Hemorrhage: Transcranial Doppler Sonography Study

The Nerve ◽

10.21129/nerve.2020.6.1.1 ◽

2020 ◽

Vol 6 (1) ◽

pp. 1-6

Author(s):

Jong Seon Park ◽

Sung-Kyun Hwang

Keyword(s):

Blood Flow ◽

Intracerebral Hemorrhage ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Transcranial Doppler ◽

Doppler Sonography ◽

Transcranial Doppler Sonography ◽

Artery Blood Flow ◽

Acute Intracerebral Hemorrhage

Download Full-text

Transcranial Doppler combined with quantitative electroencephalography brain function monitoring for estimating the prognosis of patients with posterior circulation cerebral infarction

10.21203/rs.3.rs-64085/v1 ◽

2020 ◽

Author(s):

Yanting Cao ◽

Xiaonan Song ◽

Lijuan Wang ◽

Yajie Qi ◽

Ying Chen ◽

...

Keyword(s):

Cerebral Infarction ◽

Roc Curve ◽

Transcranial Doppler ◽

Brain Function ◽

Predictive Accuracy ◽

Cox Proportional Hazards ◽

Posterior Circulation ◽

Quantitative Electroencephalography ◽

Roc Curve Analysis ◽

Brain Function Monitoring

Abstract Background: Posterior circulation cerebral infarction (PCCI) leads to decreased cerebral blood flow (CBF) and metabolism. Neural activity is closely related to regional CBF both spatially and temporally. Transcranial Doppler (TCD) combined with quantitative electroencephalography (QEEG) can evaluate neurovascular coupling and involves synergy between the metabolic and vascular systems. This study aimed to monitor brain function using TCD-QEEG and estimate its efficacy in predicting the prognosis of patients with PCCI.Methods: We used TCD-QEEG to perform quantitative brain function monitoring; we recorded the related clinical variables simultaneously. The data were analyzed using a Cox proportional hazards regression model. Receiver-operating characteristic (ROC) curve analysis was used to evaluate the cut-off for the diastolic flow velocity (VD) and (delta+theta)/(alpha+beta) ratio (DTABR). The area under the ROC curve (AUROC) was calculated to assess the predictive validity of the study variables. Results: Forty patients (aged 63.7±9.9 years; 30 men) were assessed. Mortality at 90 days was 40%. The TCD indicators of VD (hazards ratio [HR] 0.168, confidence interval [CI] 0.047–0.597, p=0.006), and QEEG indicators of DTABR (HR 12.527, CI 1.637–95.846, p=0.015) were the independent predictors of the clinical outcomes. The AUROC after the combination of VD and DTABR was 0.896 and showed better predictive accuracy than the Glasgow Coma Scale score (0.75), VD (0.76), and DTABR (0.781; all p<0.05).Conclusion: TCD-QEEG provides a good understanding of the coupling mechanisms in the brain and can improve our ability to predict the prognosis of patients with PCCI.

Download Full-text