Abstract: Objective: To assess the ability of routine electroencephalography (rEEG) to predict delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH).
Methods: Single-center prospective study including adult patients with aSAH. Two rEEG recordings with quantitative analysis and transcranial Doppler sonography (TCD) were performed, within the first 72 h (EEG1 and TCD1) and between days 4?7 (EEG2 and TCD2). Multivariate logistic regression was performed to identify DCI predictors.
Results: Seventeen (25.4 %) of 67 patients developed DCI. In qualitative analysis, no patient with a normal EEG1 had DCI, while in EEG2, the absence of bilateral posterior alpha rhythm was more frequently observed in patients with DCI (52.9 % vs 20 %; p = 0.009). Quantitative EEG2 analysis revealed significantly higher total, delta, and theta power in DCI patients, with lower alpha-beta/theta-delta ratio and edge. Delta power 4.5 uV in EEG2 showed higher sensitivity than vasospasm on TCD2 but lower specificity. Age (OR 1.08; p = 0.04), vasospasm on TCD2 (OR 41.01; p = 0.003) and delta power 4.5 uV in EEG2 (OR 4.30; p = 0.06) were independent predictors of DCI.
Conclusions: rEEG with quantitative analysis is a useful tool for predicting DCI.
Significance: Integration of rEEG and TCD may improve detection of DCI in aSAH patients.
