[1]孙婧,刘晓庆,王钦鹏,等.脑电图和经颅多普勒超声在迟发性脑缺血中的应用[J].中国临床神经外科杂志,2024,29(09):565-569.[doi:10.13798/j.issn.1009-153X.2024.09.013]
 SUN Jing,LIU Xiao-qing,WANG Qin-peng,et al.Application of electroencephalogram and transcranial Doppler ultrasound in delayed cerebral ischemia[J].,2024,29(09):565-569.[doi:10.13798/j.issn.1009-153X.2024.09.013]
点击复制

脑电图和经颅多普勒超声在迟发性脑缺血中的应用()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年09期
页码:
565-569
栏目:
综述
出版日期:
2024-09-30

文章信息/Info

Title:
Application of electroencephalogram and transcranial Doppler ultrasound in delayed cerebral ischemia
文章编号:
1009-153X(2024)09-0565-05
作者:
孙婧刘晓庆王钦鹏王国娟梁成
730030 兰州,兰州大学第二医院神经内科(孙 婧、王钦鹏、王国娟、梁 成);046099 山西长治,长治医学院附属和平医院康复医学科(刘晓庆)
Author(s):
SUN Jing1 LIU Xiao-qing2 WANG Qin-peng1 WANG Guo-juan1 LIANG cheng1
1. Department of Neurology, The Second Hospital of Lanzhou University, Lanzhou 730030, China; 2. Department of Rehabilitation Medicine, Heping Hospital Affilated to Changzhi Medical College, Changzhi 046099, China
关键词:
蛛网膜下腔出血迟发性脑缺血经颅多普勒超声脑电图
Keywords:
Delayed cerebral ischemia Subarachnoid hemorrhage Transcranial Doppler ultrasound Electroencephalogram
分类号:
R 743.9
DOI:
10.13798/j.issn.1009-153X.2024.09.013
文献标志码:
A
摘要:
迟发性脑缺血(DCI)是蛛网膜下腔出血(SAH)最常见的致残性并发症,1/3~1/2的动脉瘤性SAH发病2周内出现DCI,导致局灶性神经功能缺损、认知功能障碍、意识水平下降,严重影响病人预后。DCI的发病机制复杂,早期预测并干预是改善DCI病人预后的关键。连续、无创监测有助于早期筛选高危病人,尽早干预,从而改善病人的预后。经颅多普勒超声(TCD)和脑电图(EEG)是临床常用的非侵入性监测方法。本文就TCD和EEG在DCI中应用进展进行综述,为临床提供参考。
Abstract:
Delayed cerebral ischemia (DCI) is the most common disabling complication of subarachnoid hemorrhage (SAH). One-third to one-half of patients with aneurysmal SAH develop DCI within two weeks after the onset, resulting in focal neurological deficits, cognitive dysfunction, and a decline in the level of consciousness, which severely affects the prognosis of patients. The pathogenesis of DCI is complex, and early prediction and intervention are the keys to improving the prognosis of patients with DCI. Continuous and non-invasive monitoring is helpful for early screening of high-risk patients and early intervention, thereby improving the prognosis of patients. Transcranial Doppler ultrasound (TCD) and electroencephalogram (EEG) are commonly used non-invasive monitoring methods in clinical practice. This article reviews the application progress of TCD and EEG in DCI to provide references for clinical practice.

参考文献/References:

[1]FU HL, JING WJ, LU JY. Correlation of serum levels of miR-149-3p and CXCR3 with delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage[J]. Chin J Clin Neurosurg, 2023, 28(1): 11-14.付宏亮,景文记,卢俊义. 血清miR-149-3p和CXCR3水平与aSAH后迟发性脑缺血的相关性分析[J]. 中国临床神经外科杂志,2023,28(1):11-14.
[2]IKRAM A, JAVAID MA, ORTEGA-GUTIERREZ S, et al. Delayed cerebral ischemia after subarachnoid hemorrhage[J]. J Stroke Cerebrovasc Dis, 2021, 30(11): 106064.
[3]PAVELKA M, NECARSULMER J, HO J, et al. Vasospasm risk following aneurysmal subara-chnoid hemorrhage in older adults[J]. J Neurosurg, 2023, 139(5): 1302-1310.
[4]INAGAWA T, YAHARA K, OHBAYASHI N. Risk factors associated with cerebral vasospas-m following aneurysmal subarachnoid hemorrhage[J]. Neurol Med Chir (Tokyo), 2014, 54(6): 465-473.
[5]JOOS GS, GOTTSCHALK A, EWELT C, et al. Risk factors associated with vasospasm after non-traumatic subarachnoid hemorrhage: a retrospective analysis of 456 patients[J]. J Neurosurg Sci, 2023, 67(5): 576-584.
[6]FOREMAN PM, CHUA MH, HARRIGAN MR, et al. External validation of the practical risk chart for the prediction of delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage[J]. J Neurosurg, 2017, 126(5): 1530-1536.
[7]MCBRIDE DW, BLACKBURN SL, PEEYUSH KT, et al. The role of thromboinflammation in delayed cerebral ischemia after subarach-noid hemorrhage[J]. Front Neurol, 2017, 8: 555.
[8]VIDERMAN D, TAPINOVA K, ABDILDIN YG. Mechanisms ofcerebral vasospasm and cerebral ischaemia in subarachnoid haemorrhage[J]. Clin Physiol Funct Imaging, 2023, 43(1): 1-9.
[9]SUZUKI H, KAWAKITA F, ASADA R. Neuroelectric mechanisms of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage[J]. Int J Mol Sci, 2022, 23(6): 3102.
[10]SIVAKUMAR S, TSETSOU S, PATEL AB, et al. Cortical spreading depolarizations and clinically measured scalp EEG activity after aneurysmal subarachnoid hemorrhage and traumatic brain injury [J]. Neurocrit Care, 2022, 37(Suppl 1): 49-59.
[11]SPEARS WE, GREER DM, NGUYEN TN. Comment on the 2023 guidelines for the management of patients with aneurysmal subarachnoid hemorrhage[J]. Stroke, 2023, 54(10): 2708-2712.
[12]DE OLIVEIRA MANOEL AL, JAJA BN, GERMANS MR, et al. The VASOGRADE: a simple grading scale for prediction of delayed cerebral ischemia after subarachnoid hemorrhage[J]. Stroke, 2015,46(7): 1826-1831.
[13]PICETTI E, BOUZAT P, BADER MK, et al. A survey on monitoring and management of cerebral vasospasm and delayed cerebral ischemia after subarachnoid hemorrhage: the mantra study[J]. J Neurosurg Anesthesiol, 2024, 36(3): 258-265.
[14]WANG Q, WANG T, LIU YW, et al. The monitoring and application of transcranial doppler ultrasound in patients with severe neurovas-cular disease[J]. J Sichuan Univ ( Med Sci Edi ), 2020, 51(4): 578-581.王 琼,王 涛,刘逸文,等. 床旁经颅多普勒超声在神经重症脑血管疾病患者中的监测及应用[J]. 四川大学学报(医学版),2020,51(4):578-581.
[15]SCHERLE MATAMOROS CE, SAMANIEGO EA, SAM K, et al. Prediction of symptomatic vasospasm in patients with aneurysmal subarachnoid hemorrhage using early transcranial Doppler[J]. J Vasc Interv Neurol, 2020, 11(1): 19-26.
[16]KUMAR G, SHAHRIPOUR RB, HARRIGAN MR. Vasospasm on transcranial doppler is predictive of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage:a systematic review and meta-analysis[J]. J Neurosurg, 2016, 124(5): 1257-1264.
[17]WESTERMAIER T, PHAM M, STETTER C, et al. Value of trans-cranial doppler, perfusion-CT and neurological evaluation to fore-cast secondary ischemia after aneurysmal SAH[J]. Neurocrit Care, 2014, 20(3): 406-412.
[18]CONNOLLY F, SCHREIBER SJ, LEITHNER C, et al. Assessment of intracranial venous blood flow after subarachnoid hemorrhage: a new approach to diagnose vasospasm with transcranial color-coded duplex sonography[J]. J Neurosurg, 2018, 129(5): 1136-1142.
[19]GONZALEZ NR, BOSCARDIN WJ, GLENN T, et al. Vasospasm probability index: a combination of transcranial doppler velocities, cerebral blood flow, and clinical risk factors to predict cerebral vasospasm after aneurysmal subarachnoid hemorrhage[J]. J Neuro-surg, 2007, 107(6): 1101-1112.
[20]JIANG HY, CHEN H, GUO X, et al. Relationship between Linde-gaard ratio and brain tissue oxygen tension in patients with aneury-smal subarachnoid hemorrhage[J]. Chin J Clin Neurosurg, 2022, 27(8): 640-642.姜海洋,陈 虎,郭 星,等. 动脉瘤性蛛网膜下腔出血病人Lindegaard比值与脑组织氧分压的相关性[J]. 中国临床神经外科杂志,2022,27(8):640-642.
[21]KALEEM S, SWISHER CB. Utility of quantitative EEG for seizure detection in adults[J]. J Clin Neurophysiol, 2022, 39(3): 184-194.
[22]FOREMAN B, CLAASSEN J. Quantitative EEG for the detection of brain ischemia[J]. Crit Care, 2012, 16(2): 216.
[23]JANN K, KOENIG T, DIERKS T, et al. Association of individual resting state EEG alpha frequency and cerebral blood flow[J]. NeuroImage, 2010, 51(1): 365-372.
[24]VAN PUTTEN MJ, HOFMEIJER J. EEG monitoring in cerebral ischemia: basic concepts and clinical applications[J]. J Clin Neuro-physiol, 2016, 33(3): 203-210.
[25]ROTS ML, VAN PUTTEN MJ, HOEDEMAEKERS CW, et al. Continuous EEG monitoring for early detection of delayed cerebral ischemia in subarachnoid hemorrhage: a pilot study[J]. Neurocrit Care, 2016, 24(2): 207-216.
[26]YU Z, WEN D, ZHENG J, et al. Predictive accuracy of alpha-delta ratio on quantitative electroencephalography for delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage: meta-analysis[J]. World Neurosurg, 2019, 126: e510-e516.
[27]KIM JA, ROSENTHAL ES, BISWAL S, et al. Epileptiform abnor-malities predict delayed cerebral ischemia in subarachnoid hemo-rrhage[J]. Clin Neurophysiol, 2017, 128(6): 1091-1099.
[28]KIM JA, ZHENG WL, ELMER J, et al. High epileptiform discharge burden predicts delayed cerebral ischemia after subarachnoid hemorrhage[J]. Clin Neurophysiol, 2022, 141: 139-146.
[29]ZHENG WL, KIM JA, ELMER J, et al. Automated EEG-based prediction of delayed cerebral ischemia after subarachnoid hemorrhage[J]. Clin Neurophysiol, 2022, 143: 97-106.
[30]YANG MT. Multimodal neurocritical monitoring[J]. Biomed J, 2020,43(3): 226-230.
[31]LABAK CM, SHAMMASSIAN BH, ZHOU X, et al. Multimodality monitoring for delayed cerebral ischemia in subarachnoid hemo-rrhage: a mini review[J]. Front Neurol, 2022, 13: 869107.
[32]CHEN Y, XU W, WANG L, et al. Transcranial doppler combined with quantitative EEG brain function monitoring and outcome prediction in patients with severe acute intracerebral hemorrhage[J]. Crit Care, 2018, 22(1): 36.
[33]CAO Y, SONG X, WANG L, et al. Transcranial doppler combined with quantitative electroencephalography brain function monitoring for estimating the prognosis of patients with posterior circulation cerebral infarction[J]. Front Neurol, 2021, 12: 600985.
[34]CHEN Y, WANG L, ZHANG J, et al. Monitoring of patients with brainstem hemorrhage: a simultaneous study of quantitative electro-encephalography and transcranial Doppler[J]. Clin Neurophysiol, 2021, 132(4): 946-952.
[35]QI Y, XING Y, WANG L, et al. Multimodal monitoring in large hemispheric infarction: quantitative electroencephalography combined with transcranial doppler for prognosis prediction[J]. Front Neurol, 2021, 12: 724571.
[36]CHEN HY, ELMER J, ZAFAR SF, et al. Combining transcranial Doppler and EEG data to predict delayed cerebral ischemia after subarachnoid hemorrhage[J]. Neurology, 2022, 98(5): e459-e469.
[37]QI LX, LI ZR, YAO Y, et al. Predictive value of quantitative EEG combined with transcranial Doppler ultrasound on delayed cerebral ischemia after aneurysmal subarachnoid hemorrhages[J]. Pract J Cardiac Cerebral Pneumal Vasc Dis, 2022, 30(4): 99-103.齐丽霞,李自如,姚 远,等. 定量脑电图联合经颅多普勒超声对动脉瘤蛛网膜下腔出血后迟发性脑缺血的预测价值研究[J]. 实用心脑肺血管病杂志,2022,30(4):99-103.

相似文献/References:

[1]旷仁钊 唐晓平 漆 建 苟章洋.丹红注射液对大鼠蛛网膜下腔出血后脑血管痉挛的影响[J].中国临床神经外科杂志,2015,(11):683.[doi:10.13798/j.issn.1009-153X.2015.11.014]
 KUANG Ren-zhao,TANG Xiao-ping,QI Jian,et al.Effects of Danhong on cerebral vasospasm after subara- chnoid hemorrhage in rats[J].,2015,(09):683.[doi:10.13798/j.issn.1009-153X.2015.11.014]
[2]周路桥 罗富强 彭 虎 邱成元 刘 苏 蒋国辉 田 强 罗荣武.皮瓣塌陷综合征患者颅骨修补术后继发蛛网膜下腔出血1例[J].中国临床神经外科杂志,2015,(11):704.[doi:10.13798/j.issn.1009-153X.2015.11.022]
[3]余龙洋 李亚楠 周 宇 戴冬伟 曹依群 岳志健.垂体腺瘤经蝶术后并发蛛网膜下腔出血的临床分析 (附6例报道)[J].中国临床神经外科杂志,2016,(06):372.[doi:10.13798/j.issn.1009-153X.2016.06.018]
[4]周 量 刘 丛 张昌伟.早期栓塞术治疗动脉瘤性蛛网膜下腔出血的疗效[J].中国临床神经外科杂志,2016,(07):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
 ZHOU Liang,LIU Cong,ZHANG Chang-wei..Curative effect of early endovascular embolization on patients with ruptured intracranial aneurysms[J].,2016,(09):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
[5]朱作磊 综述 罗良生 审校.动脉瘤性蛛网膜下腔出血的预后相关因素研究进展[J].中国临床神经外科杂志,2016,(03):183.[doi:10.13798/j.issn.1009-153X.2016.03.020]
[6]水 涛 郭再玉 综述 马廉亭 审校.蛛网膜下腔出血后脑血管痉挛的亚低温治疗进展[J].中国临床神经外科杂志,2016,(03):185.[doi:10.13798/j.issn.1009-153X.2016.03.021]
[7]赵建伍 于耀宇 余天垒 李延良 唐 铸 桂 铮 周 欣 姬文婕.黄芪甲苷对大鼠蛛网膜下腔出血后脑血管痉挛的影响[J].中国临床神经外科杂志,2015,(06):350.[doi:10.13798/j.issn.1009-153X.2015.06.010]
 ZHAO Jian-wu,YU Yao-yu,YU Tian-lei,et al.Effects of Astragaloside Ⅳ on delayed cerebral vasospasm after subarachnoid hemorrhage[J].,2015,(09):350.[doi:10.13798/j.issn.1009-153X.2015.06.010]
[8]祝 源 李 俊 陈 刚 向伟楚 李国栋 赵曰圆 李欢欢 汤 伟 金二亮 马廉亭.两次DSA阴性的颅内破裂动脉瘤1例报道并文献复习[J].中国临床神经外科杂志,2015,(09):538.[doi:10.13798/j.issn.1009-153X.2015.09.009]
 ZHU Yuan,LI Jun,CHEN Gang,et al.Both negative DSA findings in 1 patient with ruptured intracranial aneurysm (case report and review of literature)[J].,2015,(09):538.[doi:10.13798/j.issn.1009-153X.2015.09.009]
[9]旷仁钊 综述 唐晓平 审校.蛛网膜下腔出血后脑血管痉挛药物治疗的研究进展[J].中国临床神经外科杂志,2015,(09):572.[doi:10.13798/j.issn.1009-153X.2015.09.024]
[10]陈 旭 吴 琳 冯达云 王举磊 秦怀洲 高国栋 张治国.头孢曲松钠对大鼠蛛网膜下腔出血后认知功能的影响[J].中国临床神经外科杂志,2015,(04):228.[doi:10.13798/j.issn.1009-153X.2015.04.012]
 CHEN Xu,WU Lin,FENG Da-yun,et al.Effect of ceftriaxone on cognitive function after subarachnoid hemorrhage in the adult rats[J].,2015,(09):228.[doi:10.13798/j.issn.1009-153X.2015.04.012]
[11]李朝晖 王玉贵 张孟超 综述 赵兴利 审校.CT灌注成像在动脉瘤性蛛网膜下腔出血中的 临床应用进展[J].中国临床神经外科杂志,2016,(05):313.[doi:10.13798/j.issn.1009-153X.2016.05.021]
[12]张林峰 周小兵 黄鑫根 丁 聪 汪 阳.CT灌注成像在动脉瘤性蛛网膜下腔出血中的应用[J].中国临床神经外科杂志,2022,27(04):311.[doi:10.13798/j.issn.1009-153X.2022.04.024]
[13]李荔荣,王景春,张福龙,等.血清ET-1水平与动脉瘤性蛛网膜下腔出血后迟发性脑缺血的关系[J].中国临床神经外科杂志,2023,28(10):643.[doi:10.13798/j.issn.1009-153X.2023.10.010]
 LI Li-rong,WANG Jing-chun,ZHANG Fu-long,et al.Relationship between serum ET-1 level and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage[J].,2023,28(09):643.[doi:10.13798/j.issn.1009-153X.2023.10.010]

备注/Memo

备注/Memo:
(2023-11-24收稿,2024-07-23修回)
通信作者:梁 成,Email:200107@126.com
更新日期/Last Update: 2024-09-30