• Jennifer Diedler, Marek Sykora, Eric Jüttler, Roland Veltkamp, Thorsten Steiner, and André Rupp.
• Department of Neurology, University of Heidelberg, Heidelberg, Germany. jennifer.diedler @ med.uni-heidelberg.de
• Cerebrovasc. Dis. 2010 Jan 1;29(2):162-9.

BackgroundEarly prediction of outcome after decompressive surgery for space-occupying middle cerebral artery (MCA) infarction is needed to guide further therapy. Here we applied spectral EEG analysis to determine the prognosis early after hemicraniectomy, while the patient is still treated in the intensive care unit.MethodsContinuous EEG monitoring following hemicraniectomy was performed in 10 patients with space-occupying MCA infarction. All patients were analgosedated and mechanically ventilated. The first 6 h of monitoring after surgery were evaluated by spectral analysis. Outcome measures included Glasgow Outcome Scale (GOS), Level of Consciousness Scale (LOC) and National Institute of Health Stroke Scale (NIHSS) at discharge. Outcome after 3 months was assessed by modified Rankin Scale.ResultsSix patients displayed a peak at 5-10 Hz in the EEG power spectrum. All these patients had a GOS score of 3 and an LOC score >or=7 at discharge. In contrast, the 4 patients without faster EEG activity had a GOS of 2 and LOC ConclusionsSpectral analysis in the subacute phase following hemicraniectomy may represent a parameter to predict early regain of consciousness and thus the capability and potential for further rehabilitation and favorable outcome.(c) 2009 S. Karger AG, Basel.

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