Electroencephalography as a Biomarker of Prognosis in Acute Brain Injury

Abstract

Electroencephalography (EEG) is a noninvasive tool that allows the monitoring of cerebral brain function in critically ill patients, aiding with diagnosis, management, and prognostication. Specific EEG features have shown utility in the prediction of outcomes in critically ill patients with status epilepticus, acute brain injury (ischemic stroke, intracranial hemorrhage, subarachnoid hemorrhage, and traumatic brain injury), anoxic brain injury, and toxic-metabolic encephalopathy. Studies have also found an association between particular EEG patterns and long-term functional and cognitive outcomes as well as prediction of recovery of consciousness following acute brain injury. This review summarizes these findings and demonstrates the value of utilizing EEG findings in the determination of prognosis.

Update in Pediatric Neurocritical Care: What a Neurologist Caring for Critically Ill Children Needs to Know

“…251,254,255,262 The sensitivity of these patterns decreases over time. 262 There is no pediatric-specific guidance on the optimal timing of EEG for prognostication purposes after cardiac arrest. As with the neurological exam, factors that may affect the validity of EEG results, such as sedation or edema over the recording site, should be considered.…”

“…Active areas of research include the potential utility of serum biomarkers and metabolomics, 281 282 advanced MRI techniques 283 (including diffusion tensor imaging, functional MRI [fMRI], and MR spectroscopy), and EEG markers. 262 284…”

“…239,251 An attenuated-featureless background or burst suppression 24 hours after ROSC is considered unfavorable patterns and are associated with poor outcomes, with low false-positives rates. 251,254,255,262 The sensitivity of these patterns decreases over time. 262 There is no pediatric-specific guidance on the optimal timing of EEG for prognostication purposes after cardiac arrest.…”