Monitoring severe head injury: a comparison of EEG and somatosensory evoked potentials

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
R J MoultonS J Konasiewicz

Abstract

We report on our experience with long-term monitoring of the EEG power spectrum and somatosensory evoked potentials (SSEPs) in 103 patients with severe closed head injury (Glasgow Coma Scale-GCS < or = 8). Patients were monitored for an average of 5 days post injury and monitoring was terminated when they died, regained consciousness or their intracranial physiologic parameters (primarily intracranial pressure-ICP) were stable for 2-3 days. Patients were treated according to a standard protocol that included mechanical ventilation, sedation, and neuromuscular blockade. At 7 of 9 twelve hour time intervals post injury, SSEPs were significantly (p < .05) different between outcome groups using the Glasgow Outcome Score collapsed to 3 categories. The percent slow (delta) activity in the EEG was not significantly different between outcome groups at any time point, post injury. The total power in the EEG power spectrum differed only at the last time epoch post injury (108 hr.). Based on the superior prognostic capabilities of the SSEP, we routinely base critical management decisions on SSEP values. We have not been able to rely on EEG parameters for these same decisions due to the lack of clear distinction between good and poor progn...Continue Reading

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Citations

Apr 17, 2008·European Journal of Anaesthesiology. Supplement·A AmantiniS Fossi
Sep 12, 2014·Neurocritical Care·Jan ClaassenUNKNOWN Participants in the International Multi-disciplinary Consensus Conference on Multimodality Monitoring
Jan 12, 2012·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Eric S Rosenthal
Dec 1, 2017·Journal of Clinical Monitoring and Computing·Allison BethuneNicolas Phan
Apr 16, 2021·Brain Communications·Alice O'DonnellDamian Cruse

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