Erschienen in:
28.06.2017 | Review Article
Electroencephalographic Patterns in Neurocritical Care: Pathologic Contributors or Epiphenomena?
verfasst von:
Brian Appavu, James J. Riviello
Erschienen in:
Neurocritical Care
|
Ausgabe 1/2018
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Excerpt
Status epilepticus (SE) and repetitive seizures contribute to the development and propagation of brain injury in the intensive care unit (ICU). This has led to the increased utilization of continuous electroencephalographic (cEEG) monitoring to effectively detect and treat seizures. Decades using cEEG recordings have identified several other unique electroencephalographic patterns including periodic discharges (PDs), rhythmic delta activity (RDA), cortical spreading depolarizations (CSDs), and changes in brain activity suggestive of cerebral ischemia. It is unclear whether many of these patterns represent an epiphenomenon of brain injury or physiological phenomena directly contributing to it. Neuroimaging and intracranial multimodality monitoring (MMM) techniques have advanced to allow clinicians to identify physiological changes in cerebral blood flow (CBF), brain tissue oxygenation (PbtO2), cerebral metabolism and intracranial pressure (ICP) and correlate these findings on cEEG. We define and review phenomena observed in the ICU that correlate with unique cEEG patterns, and discuss their known relationship to cerebral metabolism, blood flow and neuronal injury. …