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Published Online
on October 7, 2004

Stroke. 2004
Published online before print October 7, 2004, doi: 10.1161/01.STR.0000144649.49861.1d
A more recent version of this article appeared on November 1, 2004
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Submitted on May 21, 2004
Revised on August 8, 2004
Accepted on August 11, 2004

Continuous Quantitative EEG Monitoring in Hemispheric Stroke Patients Using the Brain Symmetry Index

Michel J.A.M. van Putten MD, PhD* and Dénes L.J. Tavy MD

From the Department of Neurology and Clinical Neurophysiology, Ziekenhuis Leyenburg, Leyweg, The Hague, the Netherlands.

* To whom correspondence should be addressed. E-mail: m.j.a.m.vanputten{at}clinicalsciencesystems.com.

Background and Purpose--There is increased awareness that continuous brain monitoring might benefit neurological patients, because it may allow detection of derangement of brain function in a possible reversible state, allowing early intervention. Here, we explore if quantitative continuous electroencephalography (cEEG) monitoring is technically feasible and possibly clinically relevant in patients with acute ischemic hemispheric stroke.

Materials and Methods--Twenty-one consecutive patients with an acute hemispheric stroke were monitored in our stroke unit, using cEEG for 12 to 24 hours on the day of admission. EEGs were quantified using a particular measure for symmetry, the brain symmetry index (BSI). This measure was subsequently correlated with the clinical condition of the patient using the National Institute of Health Stroke Scale (NIHSS).

Results--cEEG was technically feasible. We found a most satisfying positive correlation between the BSI and the NIHSS, with {rho}{approx}0.86 (P<0.01).

Conclusions--Technically, cEEG monitoring posed no major problems. It was found that the BSI correlates satisfactorily with the clinical neurological condition of our stroke patients. This suggests that the BSI can be used as a measure to monitor possible changes of brain function in this patient category.


Key words: brain symmetry index • electroencephalography • monitoring • stroke