Clinical and neurophysiological peculiarities in patients with ischemic supratentorial stroke

Authors

  • A. A. Kuznietsov

DOI:

https://doi.org/10.14739/2310-1210.2013.4.16829

Keywords:

ischemic stroke, electroencephalographic pattern, prognosis

Abstract

The aim of the work – optimization of diagnostic and prognostic arrangements in patients with ischemic supratentorial stroke in acute period by revealing of pathoneurophysiological peculiarities of realization of clinical pattern and stroke acute period outcome on the basis of clinical neurophysiological comparisons depending on the subtypes of stroke according to The Oxfordshire Community Stroke Classification.

Material and methods: Clinical and computed electroencephalography investigations of 118 patients (mean age 67,9±0,8) in acute period of ischemic supratentorial stroke (firstly appeared) was made. Depending on clinical subtype of the stroke that was detected during admission according to The Oxfordshire Community Stroke Project classification (OCSP) all patients were devided into 3 groups: 1st – 50 patients with total anterior circulation infarct (TACI-subtype), 2nd – 38 patients with partial anterior circulation infarct (PACI) and 3rd – 30 patients with lacunar infarct (LACI). Clinical examination included Rankin scale graduation and NIHSS detection. Separately for intact and affected hemisphere value of absolute (mcv2) and relative (%) spectrum rhythm activity (RSRA) of δ- (0,5-4 Hertz), θ- (4-8 Hertz), α- (8-13 Hertz), β- (13-35 Hertz) range, and θlo- (4-6 Hertz), θhi- (6-8 Hertz), αlo- (8-10 Hertz), αhi - (10-13 Hertz), βlo- (13-25 Hertz) та βhi- (25-35 Hertz) subranges were evaluated.

Results: The level of RSRA in δ- and θ-range in affected hemisphere exceeded the same parameters in patients with stroke PACI-subtype and LACI-subtype in 2,3 and 3,0 times respectively (p<0,01). The same time RSRA in α-, β-ranges, αlo-, αhi-, βlo-subranges in comparison with PACI-subtype was lower in 2,4; 2,1; 2,5; 2,4 and 1,6 times respectively (p<0,01); in comparison with LACI-subtype – in 3,4; 1,7; 3,3; 1,5 and 1,9 times respectively (p<0,01). Spectral structure of intact hemisphere EEG-pattern in patients with TACI-subtype of ischemic supratentorial stroke was characterized with evaluation of RSRA in δ- and θ-ranges, θlo-subrange in 1,8 (p<0,01), 1,6 (p<0,05) and 1,7 (p<0,01) times respectively compare to PACI-subtype due to decreasing of the RSRA of α-range and αlo-subrange in 1,6 (p<0,01) and 1,5 (p<0,05) times respectively.

It was revealed that Rankin’s scale score on 21day in patients with TACI-subtype of acute ischemic supratentorial stroke by OCSP classification correlated levels of RSRA of δ- (R=0,50, p<0,05), α-ranges (R=-0,53, p<0,05), αlo- (R=-0,43, p<0,05), αhi-subranges (R=-0,59, p<0,05), DAR (R=0,55, p<0,05), TAR (R=0,35, p<0,05), DTABR (R=0,47, p<0,05) of affected hemisphere, levels of RSRA of δ- (R=0,45, p<0,05), α- (R=-0,34, p<0,05), β-ranges (R=-0,33, p<0,05), αhi- (R=-0,39, p<0,05),  βlo- (R=-0,31, p<0,05), βhi-subranges (R=-0,30, p<0,05), DAR (R=0,42, p<0,05), TAR (R=0,29, p<0,05), DTABR (R=0,40, p<0,05) of intact hemisphere; Rankin’s scale score on 21day in patients with PACI-subtype of acute ischemic supratentorial stroke by OCSP classification correlated levels of RSRA of δ-range (R=0,47, p<0,05), DAR (R=0,41, p<0,05), DBR (R=0,36, p<0,05), DTR (R=0,35, p<0,05), DT1R (R=0,35, p<0,05) of affected hemisphere, levels of DBR (R=0,47, p<0,05), TBR (R=0,47, p<0,05), DTABR (R=0,37, p<0,05) of intact hemisphere; Rankin’s scale score on 21day in patients with LACI-subtype of acute ischemic supratentorial stroke by OCSP classification correlated levels of RSRA of θ-range (R=0,40, p<0,05), θhi- (R=0,38, p<0,05), αhi-subranges (R=-0,37, p<0,05), TAR (R=0,42, p<0,05), T2AR (R=0,41, p<0,05), TBR (R=0,36, p<0,05), DT1R (R=0,35, p<0,05) of affected hemisphere, level of T2AR (R=0,36, p<0,05) of intact hemisphere.

Conclusion. Combined evaluation of integral clinical-neurophysiological parameters of stroke subtype according OCSP classification and parameters of spectral EEG-pattern helps to optimize the diagnosis and prognosis of acute period of ischemic supratentorial stroke outcome.

 

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Published

2013-09-03

How to Cite

1.
Kuznietsov AA. Clinical and neurophysiological peculiarities in patients with ischemic supratentorial stroke. Zaporozhye Medical Journal [Internet]. 2013Sep.3 [cited 2024Nov.23];15(4). Available from: http://zmj.zsmu.edu.ua/article/view/16829

Issue

No. 4 (2013): Zaporozhye medical journal

Section

Original research

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