Prognostic Significance of Somatosensory Evoked Potentials in Traumatic Brain Stem Lesions

The Prognostic Value of Somatosensory Evoked Potentials in Traumatic Primary and Secondary Brain Stem Lesions

“…On the other hand, absence of the cortical signal bilaterally was more frequently coupled (p < 0.01) with a bad clinical outcome (85 % GOS 1 and 100 % GOS 1 + 2) than the absence of both BSR (75.8 % GOS 1 and 82.7 % GOS 1 + 2) ( Tables 4 and 5). In agreement with the literature [5,26] the present data show that traumatic primary brainstem lesions give rise to symmetric changes of N20 and CCT while secondary brainstem lesions (up to a certain compression) yield asymmetric ones. Missing or asymmetric changes in M-SSEP seem to indicate a light grade of primary or secondary brainstem lesion [5,26,27].…”

“…These investigators reported on patient Original Article groups with varying degrees of CNS lesions and with different states of illness and concluded that the loss of the cortical M-SSEP indicates an unfavourable outcome, especially if there are clinical indications of brainstem compression or damage. Our previous [5] and present investigations of traumatic brainstem lesions emphasise these assumptions. Since only few cases could be taken into account, the past report [5] leaves some unanswered questions regarding the correlation of the M-SSEP to the extent of the neurological symptoms and to the morphological changes seen in CT scan.…”

“…Our previous [5] and present investigations of traumatic brainstem lesions emphasise these assumptions. Since only few cases could be taken into account, the past report [5] leaves some unanswered questions regarding the correlation of the M-SSEP to the extent of the neurological symptoms and to the morphological changes seen in CT scan. Unanswered questions also remain with regard to outcome in cases with secondary regeneration of a bilaterally lost N20 after surgical decompression or specific cerebro-protective treatment.…”

“…There are many reports on the prognostic significance of M-SSEP in the acutely comatose [9,14], in head injuries [9,17,27] and in spontaneous intracranial haemorrhages [4,21]. There are only few reports [5,27] on the prognostic value of the M-SSEP in brainstem lesions following head injuries. The central conduction time (CCT) appears to be most relevant for the patient's survival.…”

The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

“…Further studies have shown that at day 3, these studies may predict cognitive functions, such as attention, concentration, processing speed, and working memory [123]. In addition, repeated SSEP measures may also help detect patients with brainstem herniation due to interruption of these functional connections [124], or with cerebral ischemia correlating with jugular bulb evidence of reduced oxygen content [125]. Changes in median SSEP may precede the rise in intracranial pressure 30% of the time [126].…”