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Monitoring Severe Head Injury: a Comparison of EEG and Somatosensory Evoked Potentials

Published online by Cambridge University Press:  18 September 2015

Richard J. Moulton ,
Jennifer I.M. Brown  and
Stefan J. Konasiewicz
Richard J. Moulton*
Affiliation:
Division of Neurosurgery, St. Michael's Hospital, and the University of Toronto, Toronto, Ontario
Jennifer I.M. Brown
Affiliation:
Division of Neurosurgery, St. Michael's Hospital, and the University of Toronto, Toronto, Ontario
Stefan J. Konasiewicz
Affiliation:
Division of Neurosurgery, St. Michael's Hospital, and the University of Toronto, Toronto, Ontario
*
Division of Neurosurgery, 38 Shuter Street, Toronto, Ontario, Canada M5B 1A6
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Abstract

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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 ≤ 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 prognosis groups based on common EEG parameters.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 25 , Issue S1 , February 1998 , pp. S7 - S11
Copyright
Copyright © Canadian Neurological Sciences Federation 1998

References

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