The Prognostic Value of Quantitative Electroencephalography Combined with Transcranial Doppler in Patients with Ischemic Stroke in Neurological Intensive Care Units

Introduction We investigated whether quantitative electroencephalography (QEEG) and transcranial Doppler (TCD) have prognostic value in determining functional outcomes six months following ischemic stroke. Methods We performed TCD monitoring on middle cerebral artery (MCA) blood flow, QEEG, and the National Institutes of Health Stroke Scale (NIHSS) on 22 patients presenting with severe acute supratentorial ischemic stroke 24–72 h post-stroke. The MCA waveforms in the ischemic hemisphere (MIH) were graded as follows: 0, absent; 1, blunted; 2, stenotic; and 3, normal. Patient follow-ups were conducted after six months, and patient outcomes were assessed using the modified Rankin scale (mRS). Finally, we compared the NIHSS, area of infarction, MIH grades, and QEEG parameters between survivors and deceased patients. Results The risk of death was highest in patients with MIH grade 0 (80%). Relative delta power was significantly correlated with mRS score at month 6 (Spearman’s rho = 0.829, P < 0.01). In the receiver operating characteristic (ROC) analysis, death was predicted by relative delta power with an overall accuracy of 86.36%. The best combination for prediction of mortality was obtained by the combination of MIH with relative delta power with an area-under the curve of 1. The moderate disability group was predicted by relative theta power with an overall accuracy of 92.86%. Conclusions QEEG and TCD may have prognostic value in determining functional outcomes in patients with acute supratentorial infarction.