Acute spontaneous intracerebral hemorrhage lethal outcome prediction on the ground of bioelectrical brain activity spectral analysis

Abstract

Aim of the study — to detect electroencephalographic criteria of unfavorable vital outcome of spontaneous supratentorial intracerebral hemorrhage (SSICH). Prospective cohort study of 156 patients (mean age 66,7 ± 0.8 years) in acute period of SSICH on the ground of conservative treatment. Diagnosis was made based on clinical neurological and visualization data. Bioelectrical brain activity was done during first 2 days of the onset. Logistic regressive analysis was used for elaboration of prognostic criteria. It was detected, that risk of lethal SSICH outcome is independently associated with the next spectral EEG‑pattern parameters: relative spectral rhythm of δ-band of intact hemisphere (odds ratio (OR) (95 % confidence interval (CI) is equal to 1.12 (1.08—1.17), p < 0.0001), frontal occipital rhythm gradient of α-band of intact hemisphere (ОR (95 % CI) = 5,96 (1.08—33.04), p = 0.0410) and interhemispheric asymmetry of absolute spectral rhythm power of β2-band (OR (95 % CI) = 0.03 (0.001—0.88), p = 0.0419). These predictors were integrated into the mathematic model for individual prognosis of SSICH lethal outcome (AUC (95 % CI) = 0.95 (0.90—0.98), p < 0.0001, predictive accuracy is equal to 89.7 %). Bilateral predominance of electroencephalographic pattern of δ-band rhythm, inversion of negative frontal occipital rhythm gradients of α-band in both hemispheres, formation of negative interhemispheric asymmetry of absolute spectral rhythm power of δ-band, α2-band in frontal region and θ-, β-bands in parietal occipital regions in first 2 days from the SSICH onset are the EEG criteria for unfavorable vital outcome of SSICH.