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Early detection of brainstem herniation using electroencephalography monitoring – case report
BACKGROUND: Continuous electroencephalography (cEEG) is an important neuromonitoring tool in brain injured patients. It is commonly used for detection of seizure but can also be used to monitor changes in cerebral blood flow. One such event that can cause a change in cerebral blood flow is imminent,...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647882/ https://www.ncbi.nlm.nih.gov/pubmed/33158418 http://dx.doi.org/10.1186/s12883-020-01988-7 |
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author | Mullaguri, Naresh Beary, Jonathan M. Newey, Christopher R. |
author_facet | Mullaguri, Naresh Beary, Jonathan M. Newey, Christopher R. |
author_sort | Mullaguri, Naresh |
collection | PubMed |
description | BACKGROUND: Continuous electroencephalography (cEEG) is an important neuromonitoring tool in brain injured patients. It is commonly used for detection of seizure but can also be used to monitor changes in cerebral blood flow. One such event that can cause a change in cerebral blood flow is imminent, cerebral herniation. cEEG monitoring and quantitative electroencephalography (QEEG) can be used as neurotelemetry to detect cerebral herniation prior to onset of clinical signs. CASE PRESENTATION: We discuss two cases highlighting the use of cEEG in cerebral herniation accompanied by clinical examination changes. The first case is a patient with multiorgan failure and intracerebral hemorrhage (ICH). Given his coagulopathy status, his ICH expanded. The second case is a patient with intraventricular hemorrhage and worsening obstructive hydrocephalus. In both cases, the cEEG showed increasing regional/lateralized slowing. The Quantitative electroencephalography (QEEG) showed a decrease in frequencies, worsening asymmetry, decreasing amplitude and increasing burst suppression ratio corresponding with the ongoing herniation. Clinically, these changes on cEEG preceded the bedside neurological changes by up to 1 h. CONCLUSIONS: The use of cEEG to monitor patients at high risk for herniation syndromes may identify changes earlier than bedside clinical exam. This earlier identification may allow for an earlier opportunity to intervene. |
format | Online Article Text |
id | pubmed-7647882 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-76478822020-11-09 Early detection of brainstem herniation using electroencephalography monitoring – case report Mullaguri, Naresh Beary, Jonathan M. Newey, Christopher R. BMC Neurol Case Report BACKGROUND: Continuous electroencephalography (cEEG) is an important neuromonitoring tool in brain injured patients. It is commonly used for detection of seizure but can also be used to monitor changes in cerebral blood flow. One such event that can cause a change in cerebral blood flow is imminent, cerebral herniation. cEEG monitoring and quantitative electroencephalography (QEEG) can be used as neurotelemetry to detect cerebral herniation prior to onset of clinical signs. CASE PRESENTATION: We discuss two cases highlighting the use of cEEG in cerebral herniation accompanied by clinical examination changes. The first case is a patient with multiorgan failure and intracerebral hemorrhage (ICH). Given his coagulopathy status, his ICH expanded. The second case is a patient with intraventricular hemorrhage and worsening obstructive hydrocephalus. In both cases, the cEEG showed increasing regional/lateralized slowing. The Quantitative electroencephalography (QEEG) showed a decrease in frequencies, worsening asymmetry, decreasing amplitude and increasing burst suppression ratio corresponding with the ongoing herniation. Clinically, these changes on cEEG preceded the bedside neurological changes by up to 1 h. CONCLUSIONS: The use of cEEG to monitor patients at high risk for herniation syndromes may identify changes earlier than bedside clinical exam. This earlier identification may allow for an earlier opportunity to intervene. BioMed Central 2020-11-07 /pmc/articles/PMC7647882/ /pubmed/33158418 http://dx.doi.org/10.1186/s12883-020-01988-7 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Mullaguri, Naresh Beary, Jonathan M. Newey, Christopher R. Early detection of brainstem herniation using electroencephalography monitoring – case report |
title | Early detection of brainstem herniation using electroencephalography monitoring – case report |
title_full | Early detection of brainstem herniation using electroencephalography monitoring – case report |
title_fullStr | Early detection of brainstem herniation using electroencephalography monitoring – case report |
title_full_unstemmed | Early detection of brainstem herniation using electroencephalography monitoring – case report |
title_short | Early detection of brainstem herniation using electroencephalography monitoring – case report |
title_sort | early detection of brainstem herniation using electroencephalography monitoring – case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647882/ https://www.ncbi.nlm.nih.gov/pubmed/33158418 http://dx.doi.org/10.1186/s12883-020-01988-7 |
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