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Electroencephalographic background desynchronization during cerebral blood flow reduction.

M Cursi·M V Meraviglia·G F Fanelli·R Chiesa·A Tirelli·G Comi·F Minicucci
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Abstract

OBJECTIVE: The aim of this study is to evaluate the usefulness of a spectral function detecting cerebral hypoperfusion. METHODS: Continuous electroencephalographic monitoring was employed during 47 consecutive carotid endarterectomies. Patients were assigned to 3 different groups according to the entity of electroencephalographic changes during carotid clamping (major changes: group A; moderate changes: group B; no change: group C). The desynchronization function, indicating the reduction of the 8-15 Hz band power, and the desynchronization index were calculated. RESULTS: Group A function decreased within 20s from clamping, with a constant slope (7.14). Desynchronization indexes were: 76.85% (group A), 40.23% (group B) and 15.29% (group C). Difference among groups was statistically significant (P < 0.0001). A case of syncope due to asystole is also reported, showing the same pattern in the descending phase of the function. CONCLUSIONS: The stereotyped time course of the desynchronization function describes the cerebral reaction to significant blood flow reduction. Values of desynchronization index exceeding 65% seem to correctly detect patients with cerebral hypoxic risk. SIGNIFICANCE: The analysis of the 8-15 Hz band desynchronization is helpful in the evaluation of cerebral hypoperfusion during carotid endarterectomy. This method could be employed in monitoring different clinical situations of ischemia.

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AgedCarotid ArteriesCerebrovascular CirculationConstrictionCortical SynchronizationElectroencephalographyEndarterectomyFemaleHeart ArrestHumansIntraoperative PeriodMaleMiddle AgedModels, NeurologicalSyncopeJournal Article

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M Cursi, M V Meraviglia, G F Fanelli, R Chiesa, A Tirelli, G Comi, F Minicucci. 2005-10-07. Electroencephalographic background desynchronization during cerebral blood flow reduction.. https://doi.org/10.1016/j.clinph.2005.06.026

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