Clinical Research
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Year 2022, Volume: 13 Issue: 4, 462 - 469, 01.10.2022

Mustafa Tavsanli , Mustafa Seçkin

https://doi.org/10.31067/acusaglik.1130277

Abstract

References

  • 1. Di Perri C, Thibaut A, Heine L et. al. Measuring consciousness in coma and related states. World J Radiol. 2014 Aug 28;6(8): 589-97. doi: 10.4329/wjr.v6.i8.589
  • 2. Howard RS, Holmes PA, Siddiqui A et al. Hypoxic-ischaemic brain injury: Imaging and neurophysiology abnormalities related to outcome. QJM. 2012;105(6):551-561. doi:10.1093/qjmed/hcs016
  • 3. Auer RN, Dunn JF SG. Hypoxia and related conditions. In: Graham DI LP, ed. Greenfield’S Neuropathology. 7th ed. New York: Oxford University Press; 2002:63-119.
  • 4. Busl KM, Greer DM. Hypoxic-ischemic brain injury: Pathophysiology, neuropathology and mechanisms. NeuroRehabilitation. 2010;26(1):5-13. doi:10.3233/NRE-2010-0531
  • 5. Mehta AK, Chamyal PC. TRACHEOSTOMY COMPLICATIONS AND THEIR MANAGEMENT. Med journal, Armed Forces India. 1999;55(3):197-200. doi:10.1016/S0377-1237(17)30440-9
  • 6. Patel AR, Patel AR, Singh S et al. Central Line Catheters and Associated Complications: A Review. Cureus. 2019;11(5):e4717. doi:10.7759/cureus.4717
  • 7. It C, Commons C. Prediction of Outcome in Anoxic-Ischaemic Coma.; 2006.
  • 8. Bassetti C, Bomio F, Mathis J et al. Early prognosis in coma after cardiac arrest: A prospective clinical, electrophysiological, and biochemical study of 60 patients. J Neurol Neurosurg Psychiatry. 1996;61(6):610-615. doi:10.1136/jnnp.61.6.610
  • 9. Wijdicks EFM, Hijdra A, Young GB et al. Practice parameter: Prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006;67(2):203-210. doi:10.1212/01.wnl.0000227183.21314.cd
  • 10. Young GB. Neurologic Prognosis after Cardiac Arrest. N Engl J Med. 2009;361(6):605-611. doi:10.1056/nejmcp0903466
  • 11. González RG, Schaefer PW, Buonanno FS, et al. Diffusion-weighted MR Imaging: Diagnostic Accuracy in Patients Imaged within 6 Hours of Stroke Symptom Onset. Radiology. 1999;210(1):155-162. doi:10.1148/radiology.210.1.r99ja02155
  • 12. Haku T, Miyasaka N, Kuroiwa T et al. Transient ADC change precedes persistent neuronal death in hypoxic–ischemic model in immature rats. Brain Res. 2006;1100(1):136-141. doi:https://doi.org/10.1016/j.brainres.2006.05.018
  • 13. Desmond PM, Lovell AC, Rawlinson AA et al. The value of apparent diffusion coefficient maps in early cerebral ischemia. Am J Neuroradiol. 2001;22(7):1260-1267.
  • 14. Els T, Kassubek J, Kubalek R et al. Diffusion-weighted MRI during early global cerebral hypoxia: a predictor for clinical outcome? Acta Neurol Scand. 2004;110(6):361-367. doi:https://doi.org/10.1111/j.1600-0404.2004.00342.x
  • 15. Wijdicks EFM, Campeau NG, Miller GM. MR Imaging in comatose survivors of cardiac arrest. Am J Neuroradiol. 2001;22(September):1561-1565.
  • 16. Wu O, Sorensen AG, Benner T et al. Comatose patients with cardiac arrest: Predicting clinical outcome with diffusion-weighted MR imaging. Radiology. 2009;252(1):173-181. doi:10.1148/radiol.2521081232
  • 17. Hirsch KG, Fischbein N, Mlynash M et al. Prognostic value of di ff usion-weighted MRI for post-cardiac arrest coma. 2020:1684-1692. doi:10.1212/WNL.0000000000009289
  • 18. Synek VM. Prognostically important EEG coma patterns in diffuse anoxic and traumatic encephalopathies in adults. J Clin Neurophysiol Off Publ Am Electroencephalogr Soc. 1988;5(2):161-174. doi:10.1097/00004691-198804000-00003
  • 19. Kaplan PW. Electrophysiological prognostication and brain injury from cardiac arrest. In: Seminars in Neurology. Vol 26. Copyright© 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New …; 2006:403-412.
  • 20. Sondag L, Ruijter BJ, Tjepkema-Cloostermans MC, et al. Early EEG for outcome prediction of postanoxic coma: prospective cohort study with cost-minimization analysis. Crit care. 2017;21(1):111.
  • 21. Westhall E, Rossetti AO, van Rootselaar A-F, et al. Standardized EEG interpretation accurately predicts prognosis after cardiac arrest. Neurology. 2016;86(16):1482-1490.
  • 22. Lupton JR, Kurz MC, Daya MR. Neurologic prognostication after resuscitation from cardiac arrest. 2020;(March):333-341. doi:10.1002/emp2.12109
  • 23. Mehta R, Chinthapalli K. Glasgow coma scale explained. BMJ. 2019;365:l1296. doi:10.1136/bmj.l1296
  • 24. Bang OY, Li W. Applications of diffusion-weighted imaging in diagnosis, evaluation, and treatment of acute ischemic stroke. Precis Futur Med. 2019;3(2):69-76. doi:10.23838/pfm.2019.00037
  • 25. Haupt WF, Hansen HC, Janzen RWC et al. Coma and cerebral imaging. Springerplus. 2015;4:180. doi:10.1186/s40064-015-0869-y
  • 26. Jasper HH. The ten-twenty electrode system of the International Federation. Electroencephalogr Clin Neurophysiol. 1958;10:370-375.
  • 27. Yamashita S, Morinaga T, Ohgo S et al. Prognostic value of electroencephalogram (EEG) in anoxic encephalopathy after cardiopulmonary resuscitation: relationship among anoxic period, EEG grading and outcome. Intern Med. 1995;34(2):71-76.
  • 28. Hockaday JM, Potts F, Epstein E et al. Electroencephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest. Electroencephalogr Clin Neurophysiol. 1965;18(6):575-586.
  • 29. Mlynash M, Campbell DM, Leproust EM et al. Temporal and spatial profile of brain diffusion-weighted MRI after cardiac arrest. Stroke. 2010;41(8):1665-1672.
  • 30. Wijman CAC, Mlynash M, Finley Caulfield A et al. Prognostic value of brain diffusion‐weighted imaging after cardiac arrest. Ann Neurol. 2009;65(4):394-402.
  • 31. Hirsch KG, Mlynash M, Jansen S et al. Prognostic value of a qualitative brain MRI scoring system after cardiac arrest. J Neuroimaging. 2015;25(3):430-437.
  • 32. Takahashi S, Higano S, Ishii K et al. Hypoxic brain damage: cortical laminar necrosis and delayed changes in white matter at sequential MR imaging. Radiology. 1993;189(2):449-456.
  • 33. Torbey MT, Selim M, Knorr J et al. Quantitative analysis of the loss of distinction between gray and white matter in comatose patients after cardiac arrest. Stroke. 2000;31(9):2163-2167.
  • 34. Little DM, Kraus MF, Jiam C et al. Neuroimaging of hypoxic-ischemic brain injury. NeuroRehabilitation. 2010;26(1):15-25.
  • 35. Arbelaez A, Castillo M, Mukherji SK. Diffusion-Weighted MR Imaging ofGlobal Cerebral Anoxia. Am J Neuroradiol. 1999;20(6):999-1007.
  • 36. Huang BY, Castillo M. Hypoxic-ischemic brain injury: imaging findings from birth to adulthood. Radiogr a Rev Publ Radiol Soc North Am Inc. 2008;28(2):417-439; quiz 617. doi:10.1148/rg.282075066
  • 37. Weiss N, Galanaud D, Carpentier A et al. Clinical review: Prognostic value of magnetic resonance imaging in acute brain injury and coma. Crit Care. 2007;11(5):230. doi:10.1186/cc6107
  • 38. Id RW, Wang C, He F et al. Prediction of poor outcome after hypoxic- ischemic brain injury by diffusion-weighted imaging : A systematic review and meta- analysis. 2019:1-16.

Electroencephalogram and Neuroimaging Markers of Poor Prognosis in Hypoxic-Ischemic Brain Injury

Year 2022, Volume: 13 Issue: 4, 462 - 469, 01.10.2022

Mustafa Tavsanli , Mustafa Seçkin

https://doi.org/10.31067/acusaglik.1130277

Abstract

Purpose:Hypoxic-ischemic brain injury (HIBI) can cause coma.Several factors may affect the outcome after HIBI and prediction of the prognosis is challenging in clinical practice.Magnetic Resonance Imaging (MRI) and Electroencephalogram (EEG) are two reliable tools to predict the possible outcome after brain damage.We aimed to test the utility of MRI and EEG in predicting the outcome by exploring specific lesion and electrophysiological patterns.
Method:Patients who had admitted to the intensive care unit (ICU) due to hypoxic-ischemic brain injury between January 2017 and March 2020 were retrospectively reviewed.Patients over 18 years of age with a history of cardiac arrest or respiratory problems leading to hypoxic-ischemic brain injury were included in the study.Glasgow Coma Score (GCS) was used for the level of consciousness.All patients had a Glasgow Coma Score (GCS) of <8 and had both MRI and EEG investigations.Patients were classified as having Poor Outcome (PO) and Good Outcome (GO).Poor outcome defines either death or lack of recovery in consciousness (GCS<8).MRI findings that could lead to a coma state were classified as “MRI-positive”, otherwise were classified as “MRI-negative”.EEG grading was done by a modification of the Hockaday scale
Results:Nineteen patients were evaluated. MRI-positive 7 patients showed poor outcome and only one patient showed good outcome.MRI-negative 5 patients had poor outcome whereas 6 patients had a good outcome.EEGs of the 11 patients showed Hockaday grade of at least 4 with only one patient showing good outcome.
Conclusion:Positive MRI findings are not as sensitive as EEG findings.EEG helps to a more precise prediction.The modified Hockaday scale seems to be useful for determining the cut-off points for the prediction of poor prognosis.

Keywords

Hypoxia-Ischemia Brain coma magnetic resonance imaging electroencephalography prognostic factors

References

  • 1. Di Perri C, Thibaut A, Heine L et. al. Measuring consciousness in coma and related states. World J Radiol. 2014 Aug 28;6(8): 589-97. doi: 10.4329/wjr.v6.i8.589
  • 2. Howard RS, Holmes PA, Siddiqui A et al. Hypoxic-ischaemic brain injury: Imaging and neurophysiology abnormalities related to outcome. QJM. 2012;105(6):551-561. doi:10.1093/qjmed/hcs016
  • 3. Auer RN, Dunn JF SG. Hypoxia and related conditions. In: Graham DI LP, ed. Greenfield’S Neuropathology. 7th ed. New York: Oxford University Press; 2002:63-119.
  • 4. Busl KM, Greer DM. Hypoxic-ischemic brain injury: Pathophysiology, neuropathology and mechanisms. NeuroRehabilitation. 2010;26(1):5-13. doi:10.3233/NRE-2010-0531
  • 5. Mehta AK, Chamyal PC. TRACHEOSTOMY COMPLICATIONS AND THEIR MANAGEMENT. Med journal, Armed Forces India. 1999;55(3):197-200. doi:10.1016/S0377-1237(17)30440-9
  • 6. Patel AR, Patel AR, Singh S et al. Central Line Catheters and Associated Complications: A Review. Cureus. 2019;11(5):e4717. doi:10.7759/cureus.4717
  • 7. It C, Commons C. Prediction of Outcome in Anoxic-Ischaemic Coma.; 2006.
  • 8. Bassetti C, Bomio F, Mathis J et al. Early prognosis in coma after cardiac arrest: A prospective clinical, electrophysiological, and biochemical study of 60 patients. J Neurol Neurosurg Psychiatry. 1996;61(6):610-615. doi:10.1136/jnnp.61.6.610
  • 9. Wijdicks EFM, Hijdra A, Young GB et al. Practice parameter: Prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006;67(2):203-210. doi:10.1212/01.wnl.0000227183.21314.cd
  • 10. Young GB. Neurologic Prognosis after Cardiac Arrest. N Engl J Med. 2009;361(6):605-611. doi:10.1056/nejmcp0903466
  • 11. González RG, Schaefer PW, Buonanno FS, et al. Diffusion-weighted MR Imaging: Diagnostic Accuracy in Patients Imaged within 6 Hours of Stroke Symptom Onset. Radiology. 1999;210(1):155-162. doi:10.1148/radiology.210.1.r99ja02155
  • 12. Haku T, Miyasaka N, Kuroiwa T et al. Transient ADC change precedes persistent neuronal death in hypoxic–ischemic model in immature rats. Brain Res. 2006;1100(1):136-141. doi:https://doi.org/10.1016/j.brainres.2006.05.018
  • 13. Desmond PM, Lovell AC, Rawlinson AA et al. The value of apparent diffusion coefficient maps in early cerebral ischemia. Am J Neuroradiol. 2001;22(7):1260-1267.
  • 14. Els T, Kassubek J, Kubalek R et al. Diffusion-weighted MRI during early global cerebral hypoxia: a predictor for clinical outcome? Acta Neurol Scand. 2004;110(6):361-367. doi:https://doi.org/10.1111/j.1600-0404.2004.00342.x
  • 15. Wijdicks EFM, Campeau NG, Miller GM. MR Imaging in comatose survivors of cardiac arrest. Am J Neuroradiol. 2001;22(September):1561-1565.
  • 16. Wu O, Sorensen AG, Benner T et al. Comatose patients with cardiac arrest: Predicting clinical outcome with diffusion-weighted MR imaging. Radiology. 2009;252(1):173-181. doi:10.1148/radiol.2521081232
  • 17. Hirsch KG, Fischbein N, Mlynash M et al. Prognostic value of di ff usion-weighted MRI for post-cardiac arrest coma. 2020:1684-1692. doi:10.1212/WNL.0000000000009289
  • 18. Synek VM. Prognostically important EEG coma patterns in diffuse anoxic and traumatic encephalopathies in adults. J Clin Neurophysiol Off Publ Am Electroencephalogr Soc. 1988;5(2):161-174. doi:10.1097/00004691-198804000-00003
  • 19. Kaplan PW. Electrophysiological prognostication and brain injury from cardiac arrest. In: Seminars in Neurology. Vol 26. Copyright© 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New …; 2006:403-412.
  • 20. Sondag L, Ruijter BJ, Tjepkema-Cloostermans MC, et al. Early EEG for outcome prediction of postanoxic coma: prospective cohort study with cost-minimization analysis. Crit care. 2017;21(1):111.
  • 21. Westhall E, Rossetti AO, van Rootselaar A-F, et al. Standardized EEG interpretation accurately predicts prognosis after cardiac arrest. Neurology. 2016;86(16):1482-1490.
  • 22. Lupton JR, Kurz MC, Daya MR. Neurologic prognostication after resuscitation from cardiac arrest. 2020;(March):333-341. doi:10.1002/emp2.12109
  • 23. Mehta R, Chinthapalli K. Glasgow coma scale explained. BMJ. 2019;365:l1296. doi:10.1136/bmj.l1296
  • 24. Bang OY, Li W. Applications of diffusion-weighted imaging in diagnosis, evaluation, and treatment of acute ischemic stroke. Precis Futur Med. 2019;3(2):69-76. doi:10.23838/pfm.2019.00037
  • 25. Haupt WF, Hansen HC, Janzen RWC et al. Coma and cerebral imaging. Springerplus. 2015;4:180. doi:10.1186/s40064-015-0869-y
  • 26. Jasper HH. The ten-twenty electrode system of the International Federation. Electroencephalogr Clin Neurophysiol. 1958;10:370-375.
  • 27. Yamashita S, Morinaga T, Ohgo S et al. Prognostic value of electroencephalogram (EEG) in anoxic encephalopathy after cardiopulmonary resuscitation: relationship among anoxic period, EEG grading and outcome. Intern Med. 1995;34(2):71-76.
  • 28. Hockaday JM, Potts F, Epstein E et al. Electroencephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest. Electroencephalogr Clin Neurophysiol. 1965;18(6):575-586.
  • 29. Mlynash M, Campbell DM, Leproust EM et al. Temporal and spatial profile of brain diffusion-weighted MRI after cardiac arrest. Stroke. 2010;41(8):1665-1672.
  • 30. Wijman CAC, Mlynash M, Finley Caulfield A et al. Prognostic value of brain diffusion‐weighted imaging after cardiac arrest. Ann Neurol. 2009;65(4):394-402.
  • 31. Hirsch KG, Mlynash M, Jansen S et al. Prognostic value of a qualitative brain MRI scoring system after cardiac arrest. J Neuroimaging. 2015;25(3):430-437.
  • 32. Takahashi S, Higano S, Ishii K et al. Hypoxic brain damage: cortical laminar necrosis and delayed changes in white matter at sequential MR imaging. Radiology. 1993;189(2):449-456.
  • 33. Torbey MT, Selim M, Knorr J et al. Quantitative analysis of the loss of distinction between gray and white matter in comatose patients after cardiac arrest. Stroke. 2000;31(9):2163-2167.
  • 34. Little DM, Kraus MF, Jiam C et al. Neuroimaging of hypoxic-ischemic brain injury. NeuroRehabilitation. 2010;26(1):15-25.
  • 35. Arbelaez A, Castillo M, Mukherji SK. Diffusion-Weighted MR Imaging ofGlobal Cerebral Anoxia. Am J Neuroradiol. 1999;20(6):999-1007.
  • 36. Huang BY, Castillo M. Hypoxic-ischemic brain injury: imaging findings from birth to adulthood. Radiogr a Rev Publ Radiol Soc North Am Inc. 2008;28(2):417-439; quiz 617. doi:10.1148/rg.282075066
  • 37. Weiss N, Galanaud D, Carpentier A et al. Clinical review: Prognostic value of magnetic resonance imaging in acute brain injury and coma. Crit Care. 2007;11(5):230. doi:10.1186/cc6107
  • 38. Id RW, Wang C, He F et al. Prediction of poor outcome after hypoxic- ischemic brain injury by diffusion-weighted imaging : A systematic review and meta- analysis. 2019:1-16.
There are 38 citations in total.

Details

Primary Language English
Subjects Neurosciences
Journal Section Research Article
Authors

Mustafa Tavsanli 0000-0002-3862-0315

Mustafa Seçkin 0000-0003-1342-8084

Publication Date October 1, 2022
Submission Date June 14, 2022
Published in Issue Year 2022Volume: 13 Issue: 4

Cite

EndNote Tavsanli M, Seçkin M (October 1, 2022) Electroencephalogram and Neuroimaging Markers of Poor Prognosis in Hypoxic-Ischemic Brain Injury. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 13 4 462–469.
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