首页> 外文期刊>Clinical EEG and neuroscience: official journal of the EEG and Clinical Neuroscience Society (ENCS) >Amplitude Instability of Somatosensory Evoked Potentials as an Indicator of Delayed Cerebral Ischemia in a Case of Subarachnoid Hemorrhage
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Amplitude Instability of Somatosensory Evoked Potentials as an Indicator of Delayed Cerebral Ischemia in a Case of Subarachnoid Hemorrhage

机译:蛛网膜下腔出血的情况下患者诱发潜在呼吸潜力的振幅不稳定性作为延迟脑缺血的指标

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摘要

We describe a 55-year-old male patient with a subarachnoid hemorrhage (SAH) as a result of left middle cerebral artery (MCA) aneurysm rupture, who underwent continuous electroencephalogram (EEG) and somatosensory evoked potential (cEEG-SEP) monitoring that showed an unusual SEP trend pattern. EEG was continuously recorded, and SEPs following stimulation of median nerves were recorded every 50 minutes, with the amplitude and latency of the cortical components automatically trended. An increase in intracranial pressure required a left decompressive craniectomy. cEEG-SEP monitoring was started on day 7, which showed a prolonged (24 hours) instability of SEPs in the left hemisphere. During this phase, left MCA vasospasm was demonstrated by transcranial Doppler (TCD), and computed tomography perfusion (CTP) showed a temporo-parieto-occipital ischemic penumbra. Following intravascular treatment, hypoperfusion and the amplitude of cortical SEPs improved. In our case, a prolonged phase of SEP amplitude instability during vasospasm in SAH correlated with a phase of ischemic penumbra, as demonstrated by CTP. In SAH, SEP instability during continuous monitoring is a pattern of alert that can allow treatments capable of avoiding irreversible neurological deterioration.
机译:我们描述了一个55岁的男性患者,其具有蛛网膜下腔出血(SAH),由于左中脑动脉(MCA)动脉瘤破裂,他接受连续脑电图(EEG)和躯体感应诱发的潜在(CEEG-SEP)监测显示一个不寻常的SEP趋势模式。脑电图持续记录,每50分钟记录刺激中位神经后的SEP,随着皮质组件自动趋势的幅度和潜伏期。颅内压的增加需要左压缩颅骨切除术。 CEEG-SEP监测在第7天开始,其延长(24小时)在左半球的SEPS不稳定性。在此阶段,通过经颅多普勒(TCD)证明了左血管痉挛,并且计算断层扫描灌注(CTP)显示了一个颞耳廓缺血性PENUMBRA。血管内治疗后,过低血压和皮质SEPs的振幅改善。在我们的情况下,在SAH的血管痉挛期间延长阶段的SEP振幅不稳定性与缺血半影的阶段相关,如CTP所证明的那样。在SAH中,连续监测期间的SEP不稳定性是一种警报模式,可以让能够避免不可逆神经劣化的治疗。

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