The prognostic value of quantitative EEG in patients undergoing mechanical thrombectomy for acute ischemic stroke

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Conference Proceeding

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Objective: We aim to validate the prognostic value of quantitative EEG (QEEG) for patients who undergo mechanical thrombectomy for acute ischemic stroke. Background: Previous work has shown that QEEG measures, specifically the delta/alpha ratio (DAR), correlate with the severity of ischemic stroke as measured by the National Institutes of Health Stroke Scale (NIHSS) (Finnigan & van Putten 2013). To our knowledge, this has not been validated long-term in patients with acute ischemic stroke who have undergone mechanical thrombectomy. Design/Methods: We collected pilot data from 24 patients (10 women, 14 men, mean age 64 years, 21 anterior circulation strokes, 3 basilar) who underwent mechanical thrombectomy at Grady Memorial Hospital (Atlanta, GA) and who also had an EEG performed during their hospital admission for other clinical indications. Representative 3-minute clips were created from the recorded EEG. For each patient, we calculated the difference in the delta-alpha ratio (DAR) between both hemispheres using all 16 standard bipolar channels using the Chronux toolbox ( in MATLAB (Natick, MA). Correlations (Spearman R) were made between the inter-hemispheric DAR difference in the acute setting and the patients' NIHSS an Modified Rankin Scale (MRS) scores upon discharge and 3 months after thrombectomy (SAS, Cary, NC). Results: In the 21 patients with hemispheric strokes, the hemisphere with the larger DAR correctly identified the laterality of stroke in 6 out of 6 right-sided and 11 out of 15 left-sided strokes (p=0.004, Fisher exact). The absolute value of the inter-hemispheric DAR difference correlated with the discharge NIHSS (R=0.59, p=0.005) and MRS (R=0.53, p=0.008) and the 90-day NIHSS (R=0.6, p=0.06) and MRS (R=0.56, p=0.004) scores. Conclusions: In this pilot data, the QEEG measure of delta-alpha ratio identified stroke laterality and correlated with discharge and 90-day NIHSS and MRS scores. This preliminary data supports the prognostic value of QEEG in ischemic stroke patients who have undergone mechanical thrombectomy.





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