ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 17 of 59
JMBS 2020, 5(5): 148–157
Clinical Medicine

Analysis of Bioelectrical Brain Activity in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage on the Ground of Conservative Therapy in Comparison with Disease Acute Period Functional Outcome

Kozyolkin O. A., Kuznietsov A. A.

Despite significant advances in basic sciences and clinical neurology, acute cerebrovascular disorders continue to be a global problem in modern medicine, occupying a leading position in the structure of causes of death and disability in most countries. Hemorrhagic stroke and its most common form spontaneous supratentorial intracerebral hemorrhage is the most destructive type of cerebrovascular disorders, which is more likely to be fatal and severely disabled than ischemic stroke. The purpose of the study was to elaborate the criteria of spontaneous supratentorial intracerebral hemorrhage acute period functional outcome on the ground of analysis of bioelectrical brain activity during conservative therapy. Material and methods. We conducted a prospective cohort study of 114 patients (mean age 67.4±0.9 years) in acute period of spontaneous supratentorial intracerebral hemorrhage on the basis of conservative therapy. Clinical and neurovisual investigation helped to set the diagnosis. Bioelectrical brain activity examination was made on 1st-2nd day and 5th-6th days of the disease onset. Logistic regression and ROC-analysis were used for prognostic criteria elaboration. Results and discussion. Unfavorable functional outcome that was evaluated as modified Rankin scale score >3 on the 21st day of the disease was detected in 53 (46.5%) cases. These patients are characterized with double-side shift (with accentuation on the affected hemisphere) of spectral rhythm power towards the slow wave activity of predominantly delta band on first-second day and the following (on 5th-6th day) absolute spectral alpha rhythm power depression in intact hemisphere on 40.9% (р=0.0054). Declining of slow wave activity in intact hemisphere (ΔDAR=-51.7%, p=0.0002) was revealed in group of patients with favorable spontaneous supratentorial intracerebral hemorrhage outcome. Mathematic model for functional outcome prognosis was elaborated. It takes into consideration the values of DAR coefficient in affected hemisphere on first-second day (ОR (95% CI) = 2.03 (1.08-3.80), р=0.0276) and DAR in intact hemisphere on 5th-6th days from the onset (ОR (95% CI) = 5.84 (2.37-14.76), р=0.0001) (AUC (95% CI) = 0.97 (0.92- 0.99), р˂0.0001, prognostic accuracy = 88.6%). Conclusion. Bioelectrical brain activity reorganization on 5th-6th day from the spontaneous supratentorial intracerebral hemorrhage onset was associated with functional disease outcome. Thus, the criteria of unfavorable functional outcome are reduction of absolute spectral alpha rhythm power and ABR coefficient in intact hemisphere, while reduction of absolute spectral delta rhythm power, DTABR and DAR coefficients in intact hemisphere were associated with favorable functional outcome

Keywords: intracerebral hemorrhage, electroencephalography, functional prognosis

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