Eeg Monitoring and Evoked Potentials in Brain Ischaemia

Prior, Pamela F.

doi:10.1093/bja/57.1.63

Cited by 107 publications

(24 citation statements)

References 39 publications

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“…The main clinical application, investigated by Prior,2 was monitoring adult patients during anaesthesia and in intensive care after cardiac arrest, during status epilepticus, and after heart surgery. A description of the device and initial experiences with it have been compiled into a well known book.…”

mentioning

confidence: 99%

Role of cerebral function monitoring in the newborn

Vries

Hellström‐Westas

2005

Archives of Disease in Childhood - Fetal and Neonatal Edition

104

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confidence: 99%

Role of cerebral function monitoring in the newborn

Vries

Hellström‐Westas

2005

Archives of Disease in Childhood - Fetal and Neonatal Edition

104

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“…qEEG seems to have a predictive value for the final clinical outcome in stroke patients and might be of importance in determin ing the risk of cerebral complications during cardiac sur gery [28]. Perioperative EEG monitoring reflects the neuronal metabolism and obtains early warning of cere bral ischemia and hypoxia in order to prevent irrevers ible brain damage [29], Three types of brain hypoxia have been known, the anemic, the ischemic and hypoxic type. The EEG changes associated with ischemic hyp oxia are very similar or even identical to those resulting from hypoxic hypoxia [11], Further, a relationship be tween the occipital alpha rhythm frequency and the cere bral blood flow as well as the number of slow waves and the amount of the oxygen in the brain circulation has been found [24,25].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Blood Transfusion on Alpha EEG Activity in Thalassemic Patients

1991

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EEG signal analysis could be very helpful in the detection of signs of adverse reaction to the brain by a systemic disease. We performed an EEG spectral analysis in 12 young patients with thalassemia before and after their regular blood transfusion, and in 10 volunteer students. Our aim was to test if the EEG analysis could detect signs of brain dysfunction due to the cerebral hypoxia as a result of the anemia. We analyzed the EEG signals on line using a dedicated computer system estimating the power of the delta, theta, alpha, sigma and beta bands of the EEG. After transfusion, the power spectral density of the alpha band showed a significant enhancement in most areas of the brain, in the group of the thalassemia patients as compared to the normals. These differences correlated with the levels of hemoglobin of the patients, and possibly reflect the degree of oxygenation of the brain. Since the visual interpretation of the EEG is not efficient for estimating the brain dysfunction in the anemic state in thalassemia, the signal analysis of the EEG may provide a more sensitive alternative to study the effects of hypoxia on brain function.

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“…26,27 In animals the EEG disappears after 15-25 see, corneal reflex in 10-90 see, and spontaneous respiration in 30-120 see after circulatory arrest. 28 Studies of complete global ischaemia using neck tourniquets in normal and schizophrenic subjects demonstrated loss of consciousness in six to seven seconds with concomitant slowing of the EEG, followed by isoeleetric EEG after 20-40 see.…”

Section: Functional and Biochemical Changes In Isehaemiamentioning

confidence: 99%

Neuroprotection, anaesthesia, and the brain

Murkin

1995

Can J Anaesth

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In clinical practice, the occurrence of both focal and global cerebral ischaemia can be observed during various situations including during cardiac surgery and circulatory arrest. Mechanisms of injury including cerebral emboil and global ischaemia, and the role of excitotoxicity and potential pharmacological interventions, will be reviewed. Focal ischaemiaThere is both indirect and direct evidence that focal ischaemic insult occurs during cardiopulmonary bypass (CPB) as a result of microgaseous and particulate emboli. The risk of embolization is influenced by several factors including type of CPB equipment employed, e.g., usage of arterial line fdtration, bubble vs membrane oxygenators. J-4 In addition, transcranial Doppler (TCD) studies have detected emboli occurring during both aortic cannulation and clamping, as well as during stable CPB. s Retinal imaging has demonstrated perfusion defects indicative of embolization, that are decreased by use of a membrane oxygenator.6 Histological studies in both experimental animals and patients exposed to CPB, as well as in patients undergoing proximal aortography only, have demonstrated brain microvascular lesions consistent with cerebral emboli.7Distinct from microemboli, the extent of aortic atherosclerosis is likely and an independent risk for overt neurological damage and cerebrovascular accident. This is both a result of fracturing and fragmentation that can occur with aortic instrumentation, as well as "shearing" of plaque as a consequence of the hydrodynamic changes from perfusion through the aortic cannula. The risk of overt neurological dysfunction associated with coronary artery bypass (CAB) surgery is generally reported to be <2%. 8,9 There is a high incidence of subtle postoperative neuropsychological dysfunction, variously reported to occur in between 48% to 79% of patients undergoing CAB surgery. 8,j~ The aetiology and importance of this cognitive dysfunction is unclear, but it is felt to reflect cerebral ischaemia occurring as a result of episodes of hypoperfusion 13 and/or gaseous and particulate microemboli during cardiopulmonary bypass (CPB). 7,s In addition, such cognitive dysfunction may also be partly attributable to nonspecitic stress associated with undergoing major surgery, and is at least partly independent of exposure to CPB.9,'~ Global ischaemia In clinical practice, episodes of controlled global ischaemia are associated with procedures for implantable cardiovertor-defibrillator (ICD) insertion, and those employing deep hypothermic circulatory arrest (DHCA), e.g., aortic arch reconstruction and repair of congenital heart lesions. Since ICD procedures involve multiple episodes of cardiac arrest, such procedures, particularly when superimposed upon incipient or overt cerebrovascular disease (estimated as an associated phenomenon in over 60% of patients with atherosclerotic heart disease), represent multiple episodes of complete global cerebral ischaemia. While the episodes of venlricular tachycardia or fibrillation (VT or VF) are limited to durat...

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Eeg Monitoring and Evoked Potentials in Brain Ischaemia

Cited by 107 publications

References 39 publications

Role of cerebral function monitoring in the newborn

Role of cerebral function monitoring in the newborn

The Effect of Blood Transfusion on Alpha EEG Activity in Thalassemic Patients

Neuroprotection, anaesthesia, and the brain

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