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首页> 外文期刊>Neurosurgical focus >Somatosensory evoked potentials in patients with high-grade aneurysmal subarachnoid hemorrhage
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Somatosensory evoked potentials in patients with high-grade aneurysmal subarachnoid hemorrhage

机译：严重动脉瘤性蛛网膜下腔出血患者的体感诱发电位

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OBJECTIVE The aim of this prospective study was to investigate the value of somatosensory evoked potentials (SEPs) in predicting outcome in patients with high-grade aneurysmal subarachnoid hemorrhage (SAH). METHODS Between January 2013 and January 2015, 48 patients with high-grade SAH (Hunt and Hess Grade III, IV, or V) who were admitted within 3 days after hemorrhage were enrolled in the study. Right and left median and tibial nerve SEPs were recorded on Day 3 after hemorrhage and recorded again 2 weeks later. Glasgow Outcome Scale (GOS) scores were determined 6 months after hemorrhage and dichotomized as poor (Scores 1–3) or good (Scores 4–5). Results of SEP measurements were dichotomized (present or missing cortical responses or normal or prolonged latencies) for each nerve and side. These variables were summed and tested using logistic regression and a receiver operating characteristic curve to assess the value of SEPs in predicting long-term outcome. RESULTS At the 6-month follow-up visit, 29 (60.4%) patients had a good outcome, and 19 (39.6%) had a poor outcome. The first SEP measurement did not correlate with clinical outcome (area under the curve [AUC] 0.69, p = 0.52). At the second measurement of median nerve SEPs, all patients with a good outcome had cortical responses present bilaterally, and none of them had bilateral prolonged latencies (p = 0.014 and 0.003, respectively). In tibial nerve SEPs, 7.7% of the patients with a good GOS score had one or more missing cortical responses, and bilateral prolonged latencies were found in 23% (p = 0.001 and 0.034, respectively). The second measurement correlated with the outcome regarding each of the median and tibial nerve SEPs and the combination of both (AUC 0.75 [p = 0.010], 0.793 [p = 0.003], and 0.81 [p = 0.001], respectively). CONCLUSIONS Early SEP measurement after SAH did not correlate with clinical outcome, but measurement of median and tibial nerve SEPs 2 weeks after a hemorrhage did predict long-term outcome in patients with high-grade SAH.
机译：目的这项前瞻性研究的目的是研究体感诱发电位（SEP）在预测高级别动脉瘤性蛛网膜下腔出血（SAH）患者预后中的价值。方法在2013年1月至2015年1月期间，对48例在出血后3天内入院的SAH高危患者（Hunt和Hess III，IV或V级）进行了研究。出血后第3天记录左右中和胫骨神经SEP，2周后再次记录。在出血后6个月确定格拉斯哥预后量表（GOS）评分，并将其分为不良（评分1-3）或良好（评分4-5）。将每条神经和一侧的SEP测量结果二分（存在或缺失皮质反应或正常或长时间潜伏期）。对这些变量进行求和，并使用逻辑回归和接收器工作特征曲线进行测试，以评估SEP在预测长期预后中的价值。结果在为期6个月的随访中，有29例（60.4％）的患者预后良好，而19例（39.6％）的预后较差。首次SEP测量与临床结果无关（曲线下面积[AUC] 0.69，p = 0.52）。在第二次测量中位神经SEP时，所有预后良好的患者均出现双侧皮质反应，而没有一个患者双侧潜伏期延长（分别为p = 0.014和0.003）。在胫神经SEPs中，GOS评分良好的患者中有7.7％的患者皮层反应缺失一个或多个，而双侧潜伏期较长的潜伏期为23％（分别为p = 0.001和0.034）。第二个测量值与每个正中神经和胫神经SEP以及两者的组合相关（AUC 0.75 [p = 0.010]，0.793 [p = 0.003]和0.81 [p = 0.001]）。结论SAH后早期SEP的测量与临床结果无关，但是出血2周后测量中位和胫神经SEP确实可以预测高级别SAH患者的长期预后。

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