PROGNOSTIC VALUE OF INTEGRATED ELECTROENCEPHALOGRAPHIC PATTERN ASSESSMENT IN PATIENTS WITH ACUTE SPONTANEOUS SUPRATENTORIAL INTRACEREBRAL HEMORRHAGE ON THE GROUND OF CONSERVATIVE THERAPY

Kozyolkin O., Kuznietsov A

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Aim of the study – to estimate the informative value of electroencephalographic (EEG) pattern for assessment the individual acute period outcome prognosis of the spontaneous supratentorial intracerebral hemorrhage (SSICH) on the ground of conservative therapy. Object and methods. 156 patients were examined in acute period of SSICH on the ground of conservative therapy. The diagnosis was made based on clinical and neurovizualization investigation. The estimation of cerebral structures functional statement was made by using computed EEG with spectral rhythm power analysis of brain activity during first 48 hours from the disease onset. The outcome of acute SSICH was evaluated on 21st day using modified Rankin Scale (mRS). The mRS score >3 was the criteria of unfavorable functional outcome, the mRS score ≤3 – favorable outcome. Cluster analysis was used for integrated EEG type identification. Results. І type of EEG pattern was diagnosed in 45 (28,8%) patients, II type – in 53 (34%) cases, III type – in 58 (37,2%) cases. The most valuable violations of bioelectrical brain activity were revealed in patients with III type of EEG pattern (bilateral prevalence of δ-rhythm spectral power together with inversion of negative fronto-occipital α-rhythm power gradients). II type of EEG pattern was characterized by predominantly slow-wave activity (without prevalence of δ-rhythm power) with ipsilateral reduction of fronto-occipital β-rhythm gradient. Absence of slowwave activity prevalence in both hemispheres with the preservation of the zone differences in α- and β-rhythms were typical for I type of EEG pattern. The frequency of lethal outcome was the highest in patients with III type of EEG pattern (69% versus 1,8% and 2,2% in I and II types respectively). Presence of I type was more favorable (77,8% versus 49,1% in patients with II type of EEG pattern). There was no favorable functional outcome of SSICH in patients with III type. Conclusions. Integrated type of EEG pattern takes into account the combination of the parameters that summarize the relations of affected and intact hemisphere rhythms, intra- and inter hemispheric bioelectrical brain activity arrangement during first 48 hours from the onset of SSIH. Integrated type of EEG pattern closely correlates with the SSIСH acute period outcome (Chi-squared Pearson = 108,1, р˂0,0001).

intracerebral hemorrhage, electroencephalography, prognosis.

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«Bulletin of problems biology and medicine» Issue 4 (158), 2020 year, 151-156 pages, index UDK 616.831-005.1-021.3-039.73-037:616.831-073.756.8

10.29254/2077-4214-2020-4-158-151-156