| [Objective]:This study aimed at exploring the early diagnostic value of the relative band power (RBP) of EEG in the acute ischemic stroke of internal carotid artery system and the clinical application value for prognostic evaluation in the severe stroke by observeing the distribution difference of relative band power between acute massive cerebral infarction and focal cerebral infarction of the internal carotid artery system with negative CT and dynamically monitoring the change trend of relative band power in acute massive middle cerebral artery cerebral infarction in the different time range after onset.At last,we intend to supply an objective and intuitive, easy to carry out beside the bed method for monitoring cerebral function in Stroke Unit.[Method]:This research team is divided into early diagnosis group and dynamic trends group, and the two groups are set of control group respectively.Early diagnosis group:The team bring into a total of38patients with acute cerebral infarction in internal carotid artery system (20cases of focal cerebral infarction,18cases of massive cerebral infarction),30cases of hospitalized patients with normal EEG in the corresponding period (control group).There are8channels to monitor the research group patients and the control group patients and record the routine EEG and RBP trend.we should ensure to finish the within24h of the onset to research group and everyone should be monitored at least30minutes each time.The changes of bilateral RBP were observed in the infarct of brain regions and the occipital brain areas and analyzed comparatively.RBP in the focal cerebral infarction and the massive cerebral infarction were compared with that in the control group.Dynamic trend monitoring group:The team bring into a total of30cases with acute massive middle cerebral artery infarction and30cases of hospitalized patients with normal EEG in the corresponding period (control group).we carry out bedside monitoring in the three phases of48h,5-6day,10-11day after onset and record of the patient’s general information,complications,and laboratory test results in the research group.We carry out bedside monitoring in the control group in the same time range.The research group patients are divided into survival group and death group according to whether to surviving in one month and retrospectively analyzed the trend change of RBP during the three time ranges in the two group to.We make a further comparison between survival group,death group and control group.[Results]: Part ⅠComparison of infarction regions with contralateral regions:FCI showed asymmetry on all the wave-band RBPs.The RBP of δ,θ waves on the infarct side were significantly higher than that on the normal side(P<0.01).RBPs of α,β waves were decreased significantly (P<0.01);Bilateral asymmetry existed in the large area cerebral infarction too: The RBP of δwave on the infarct side were significantly higher than that on the normal side(P<0.01).RBPs of a,p waves were decreased significantly (P<0.01),but RBPs of θ waves had not significant statistical difference (P>9.95).RBP of θ,δwaves in the two infarction groups were increased significantly compared to the control group (P<0.01).RBPs of α,β waves were decreased significantly (P<0.01).The changes of RBP in the occipitalia:The two groups infarction showed asymmetry on all the wave-band RBPs in the bilateral occipitalia. The RBP of δ,θ waves on the infarction side were significantly higher than that on the normal side(P<0.05).RBPs of α,β waves were decreased significantly (P<0.05).Comparison of nomal side of occipitalia with control group:The RBP of δ,θ waves were significantly higher and a,P waves were decreased significantly (P<0.05)in the large area cerebral infarction group.But in FCI group, RBPs of δ、α、β waves had not significant statistical difference (P>0.05) except the slight increase of θ waves.Part Ⅱ1、The change of RBP in infarction brain regions within the three phase of48h,5-6days,10-11daysThe RBP values of the wave bands of δ、θ、α、β in infarction brain regions has a tendency to change over time both the death group and survival group patients,and the variational trends are different between the two groups (P<0.05),while the RBP value of four wave bands of the control group are found no obviously change (P>0.05).The RBP values of the wave bands of δ,θ in infarction brain regions both the two groups of cerebral infarction patients are significantly higher than the control group,while the a,p wave bands are significantly lower than control group (P<0.05).The RBP values of the wave bands of δ、θ、α、β in infarction brain regions both the two groups of cerebral infarction patients have no obvious difference at the beginning of being hospitalized (P>0.05).The RBP values of the δ wave band present a sustaining rising trend in the death group between the three phases,while in the survival group,the change trend is from rise to decline,and keep only slightly higher than the first monitoring after10days,except it,the rising rate of the death group is much higher than the survival group in the second time monitoring.The RBP values of the θ wave band present a sustaining decline trend in the death group between the three phases,while in the survival group,the change trend is from decline to stability,and there is no difference between the second and the third time monitoring.The RBP values of the a wave band present a sustaining decline trend in the death group between the three phases,while in the survival group,the change trend is from stability to gradual rise,except it,the overrall trend of the a wave band in the death group is significantly lower than the survival group.The change trend of the RBP values of the β wave band is from decline to slight rebound and still below the level on admission in the last monitoring, while in the survival group,the change trend is from stability to gradual rise,except it,the overrall trend of the β wave band in the death group is significantly lower than the survival group.2、The change of RBP in the contralateral brain regions of infarction within the three phase of48h,5-6days,10-11daysThe RBP values of the wave bands of δ、θ、α、β in the contralateral brain regions of infarction has a tendency to change over time both the death group and survival group patients,and the variational trends are different between the two groups (P<0.05),while the RBP value of four wave bands of the control group are found no obviously change (P>0.05). The RBP values of the wave bands of δ,θ in the contralateral brain regions of infarction both the two groups of cerebral infarction patients are significantly higher than the control group,while the α,β wave bands are significantly lower than control group (P<0.05). The RBP values of the δ wave band present a sustaining rising trend in death group between the three phases,while in survival group,the change trend is from rise to guadual decline and back to basic level on admission after10days,except it,the overrall trend of the δ band in survival group is significantly lower than the death group and the difference has a tendency to gradually increase in three times monitoring.The RBP values of the0wave band present a sustaining decline trend in death group within the three phases, while in the survival group, the change trend is from gradual decline during6days to stability between the last two times monitoring,except it,the overrall trend of the θ wave band in death group is significantly lower than the survival group.The change trend of a wave band is from gradual decline during6days to keeping a lower levels between the last two times monitoring,while in survival group,the change trend is from decline to gradual rise and back to basic level on admission after10days,except it,the overrall trend of the a wave band in death group is significantly lower than the survival group.The change trend of β wave band is from gradual decline during6days to a slight rebound,while in the survival group,the change trend is from gradual decline to gradual rise and the third time monitoring results have been higher than the level on admission, except it, the two groups at the same level on admission but the decline rate of the death group is much higher than the survival group during the last two times monitoring.3、The paired comparisons of the change trend between the infarction cerebral regions and contralateral cerebral regionsThe RBP values of the wave bands of δ、θ、α、β in the bilateral cerebral regions of infarction have a tendency to change over time both the death group and the survival group patients.The change trend of the four bands in the bilateral cerebral regions is inconsistent in death group, while in the survival group, the change trend of the δ、α、β wave bands of the bilateral cerebral regions is inconsistent and there has no statistical difference for θ wave band.The distribution level of the four wave bands in the bilateral brain regions presents asymmetry in the two groups of cerebral infarction patients during the time in hospital and contrary to δ wave bands,the RBP values of the α、β wave bands in infarction cerebral regions were significantly lower than the contralateral cerebral area,except it,the asymmetry of a wave band between bilateral cerebral regions has a tendency to increase gradually in death group.The RBP values of the θ wave bands in infarction cerebral regions is higher than the contralateral infarction in death group on admission,then change trends are decline in the bilateral cerebral regions of infarction in the last two times monitoring and the decline rate of the infarction cerebral regions is much higher than the contralateral cerebral regions,except it, the values of the infarction cerebral regions is significantly lower than the contralateral cerebral regions in the last two times monitoring.In survival group,the distribution level of the θ wave in the bilateral brain regions presents symmetry on admission, then gradually presents the asymmetry,except it, the RBP values of the infarction cerebral regions is significantly lower than the contralateral cerebral regions in the last two times monitoring.[Conclusions]:1.RBP had an important significance of Lateralization in the acute cerebral infarction of internal carotid artery system with negative CT and it contributed to differentiating the large area cerebral infarction preliminarily combining with the change of occipital RBPs.2.The RBP values of the wave bands of δ、θ、α、β in the infarction cerebral regions and contralateral cerebral regions have a tendency to change over time in the acute massive middle cerebral artery infarction patients,and the change trends of every wave band show significant differences depending on whether they are survival or dead in one month.Dynamically monitoring the change trend of the RBP during the severe hemisphere infarction patients’ hospitalization can timely reflect the changes in brain function and have important value to evaluate the patient’s condition and the chances of survival for a month. |
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