Delta Waves in the EEGs of Patients With Intracerebral Hemorrhage

Hirose, Genjiro; Saeki, Mitsuo; Kosoegawa, H; Takado, Matsuhei; Yamamoto, Toshiyuki; Tada, Akira

doi:10.1001/archneur.1981.00510030064009

Cited by 21 publications

(5 citation statements)

References 7 publications

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“…If so, can this be done using stimulation? Following a lesion, EEG studies have shown that there is an appearance of delta waves on the ipsilesional side (Gloor et al, 1977; Hirose et al, 1981). In rats, a comparable low-frequency synchronized neuronal activity is observed in perilesional cortex after an ischemic lesion of the cortex (Carmichael and Chesselet, 2002).…”

Section: Stimulation To Favor Rewiring After Injurymentioning

confidence: 99%

Shaping plasticity to enhance recovery after injury

Dancause

Nudo

2011

Progress in Brain Research

169

127

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The past decade of neuroscience research has provided considerable evidence that the adult brain can undergo substantial reorganization following injury. For example, following an ischemic lesion, such as occurs following a stroke, there is a cascade of molecular, genetic, physiological and anatomical events that allows the remaining structures in the brain to reorganize. Often, these events are associated with recovery, suggesting that they contribute to it. Indeed, the term plasticity in stroke research has had a positive connotation historically. But more recently, efforts have been made to differentiate beneficial from detrimental changes. These notions are timely now that neurorehabilitative research is developing novel treatments to modulate, increase, or inhibit plasticity in targeted brain regions. We will review basic principles of plasticity and some of the new and exciting approaches that are currently being investigated to shape plasticity following injury in the central nervous system.

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Section: Stimulation To Favor Rewiring After Injurymentioning

confidence: 99%

Shaping plasticity to enhance recovery after injury

Dancause

Nudo

2011

Progress in Brain Research

169

127

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“…In the early stages, localized polymorphic delta wave activity appears ipsilaterally in patients with ICH without a shift of midline structures, regardless of the location of hematoma. In patients with larger hematomas of 30 mL or more, causing a shift of the midline structures, delta wave activity appears over both hemispheres, while superposition of faster frequencies on slow waves indicates the development of brain edema (25). The incidence of seizures after spontaneous ICH reportedly ranges from 2.8 to 18.7% (26).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Various Hemostasis Parameters and Neurophysiological Examinations in Spontaneous Intracerebral Hemorrhage: The IRONHEART Study Protocol

et al. 2021

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Rationale: Stroke is one of the leading causes of death in all developed countries. In Hungary, more than 10,000 patients die annually due to cerebrovascular diseases according to the WHO Mortality Database. Of these patients, 10–15 % suffer non-traumatic intracerebral hemorrhage (ICH). ICH results in a higher rate of mortality as compared to ischemic stroke and outcomes are difficult to predict. In the IRONHEART study, we aim to test various hemostasis parameters and clinical neurophysiological examinations in evaluating outcome in ICH.Methods: In this prospective, observational study, we plan to enroll consecutive patients with non-traumatic spontaneous ICH admitted to a single Stroke Center (Department of Neurology, University of Debrecen, Hungary). The protocol of the IRONHEART study includes the investigation of detailed clinical, laboratory investigations, and various neurophysiological examinations. Stroke severity is quantified based on the National Institutes of Health Stroke Scale (NIHSS) on admission and day 7, 14, and 90 after the onset of stroke. Cranial CT is performed on admission, day 14, and 90 to estimate the ICH volume. Modified Rankin Scale (mRS) is used for evaluating the long-term outcome (90 days post-event). Blood is drawn immediately on admission for specific hemostasis tests. Digital and quantitative EEG techniques and motor evoked potential (MEP) are performed to evaluate the prognosis of cerebral hemorrhage on admission (within 24–48 h), immediately before discharge (~10–14 days later), and 3 months after the event.Outcomes: The following outcomes are investigated: primary outcomes: mortality by day 14 and day 90, secondary long-term outcome at 90 days post-event where mRS 0–2 is defined as favorable long-term outcome.Discussion: If associations between outcomes and the investigated parameters (hemostasis and neurophysiological examinations) are confirmed, results might aid prognosis assessment in this subtype of stroke with particularly high mortality. Improving clinical grading systems on ICH severity and outcomes by including the investigated parameters could help to better guide the management of these patients in the future.

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“…In patients with hematomas of 30 cm 3 or larger, causing a shift of the midline structures, delta wave activity appeared over both hemispheres. At the same time, superposition of faster frequencies on slow waves indicated the development of edema in the brain ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

“…Changes in the extent of bleeding and the onset and progression of brain edema can be monitored by using digital EEG and MEP techniques. In patients with larger hematomas of 30 mL or more, causing a shift of the midline structures, delta wave activity appears over both hemispheres ( 9 ). The incidence of seizures after spontaneous ICH reportedly ranges from 2.8 to 18.7% ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Neurophysiological Examinations as Adjunctive Tool to Imaging Techniques in Spontaneous Intracerebral Hemorrhage: IRONHEART Study

et al. 2021

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Introduction: Intracerebral hemorrhage (ICH) is a devastating disease, which may lead to severe disability or even death. Although many factors may influence the outcome, neurophysiological examinations might also play a role in its course. Our aim was to examine whether the findings of electroencephalography (EEG) and transcranial magnetic stimulation (TMS) can predict the prognosis of these patients.Methods: Between June 1 2017 and June 15 2021, 116 consecutive patients with ICH were enrolled prospectively in our observational study. Clinical examinations and non-Contrast computed tomography (NCCT) scan were done on admission for ICH; follow-up NCCT scans were taken at 14 ± 2 days and at 3 months ± 7 days after stroke onset. EEG and TMS examinations were also carried out.Results: Of the patients in the study, 65.5% were male, and the mean age of the study population was 70 years. Most patients had a history of hypertension, 50.8% of whom had been untreated. In almost 20% of the cases, excessive hypertension was measured on admission, accompanied with >10 mmol/L blood glucose level, whereas their Glasgow Coma Scale was 12 on average. Presence of blood in the ventricles or subarachnoid space and high blood and perihematomal volumes meant poor prognosis. Pathological EEG was prognostic of a worse outcome. With TMS examination at 14 days, it might be possible to estimate outcome in a univariate model and the absence, or reduction of the amplitude of the motor evoked potentials was associated with poor prognosis.Conclusion: Together with the clinical symptoms, the volume of bleeding, perihematomal edema (or their combined volume), and neurophysiological examinations like EEG and TMS play an important role in the neurological outcome of patients with ICH. This might affect the patients' rehabilitation plans in the future, since with the help of the examinations the subset of patients with potential for recovery could be identified.

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Delta Waves in the EEGs of Patients With Intracerebral Hemorrhage

Cited by 21 publications

References 7 publications

Shaping plasticity to enhance recovery after injury

Shaping plasticity to enhance recovery after injury

Prognostic Value of Various Hemostasis Parameters and Neurophysiological Examinations in Spontaneous Intracerebral Hemorrhage: The IRONHEART Study Protocol

Neurophysiological Examinations as Adjunctive Tool to Imaging Techniques in Spontaneous Intracerebral Hemorrhage: IRONHEART Study

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