Electroencephalogram and Neuroimaging Markers of Poor Prognosis in Hypoxic-Ischemic Brain Injury

Authors : Mustafa Tavsanli, Mustafa Seçkin

Pages : 462-469

Doi:10.31067/acusaglik.1130277

View : 34 | Download : 7

Publication Date : 2022-10-01

Article Type : Research

Abstract :Purpose:Hypoxic-ischemic brain injury (HIBI) can cause coma.Several factors may affect the outcome after HIBI and prediction of the prognosis is challenging in clinical practice.Magnetic Resonance Imaging (MRI) and Electroencephalogram (EEG) are two reliable tools to predict the possible outcome after brain damage.We aimed to test the utility of MRI and EEG in predicting the outcome by exploring specific lesion and electrophysiological patterns. Method:Patients who had admitted to the intensive care unit (ICU) due to hypoxic-ischemic brain injury between January 2017 and March 2020 were retrospectively reviewed.Patients over 18 years of age with a history of cardiac arrest or respiratory problems leading to hypoxic-ischemic brain injury were included in the study.Glasgow Coma Score (GCS) was used for the level of consciousness.All patients had a Glasgow Coma Score (GCS) of <8 and had both MRI and EEG investigations.Patients were classified as having Poor Outcome (PO) and Good Outcome (GO).Poor outcome defines either death or lack of recovery in consciousness (GCS<8).MRI findings that could lead to a coma state were classified as "MRI-positive”, otherwise were classified as "MRI-negative”.EEG grading was done by a modification of the Hockaday scale Results:Nineteen patients were evaluated. MRI-positive 7 patients showed poor outcome and only one patient showed good outcome.MRI-negative 5 patients had poor outcome whereas 6 patients had a good outcome.EEGs of the 11 patients showed Hockaday grade of at least 4 with only one patient showing good outcome. Conclusion:Positive MRI findings are not as sensitive as EEG findings.EEG helps to a more precise prediction.The modified Hockaday scale seems to be useful for determining the cut-off points for the prediction of poor prognosis.
Keywords : Hypoxia-Ischemia, Brain, coma, magnetic resonance imaging, electroencephalography, prognostic factors