TOPLINE:
Subhairline electroencephalography (EEG) accurately detected anterior circulation large vessel occlusion (LVO-a) stroke in patients presenting to the emergency department (ED) with a suspected stroke.
METHODOLOGY:
- Identifying LVO-a strokes in the prehospital environment through a stroke triage tool can significantly reduce time to treatment, facilitating direct transportation to a comprehensive stroke center.
- Researchers evaluated diagnostic accuracy of subhairline EEG for LVO-a stroke detection in 51 patients admitted to the ED with a suspected stroke or confirmed LVO-a stroke and symptom onset time <24 hours.
- All patients underwent subhairline EEG recording after admission or prior to endovascular thrombectomy.
- Overall, 31%, 10%, and 22% of patients had an LVO-a stroke and a non-LVO-a ischemic stroke, transient ischemic attack, and another stroke mimic, respectively.
- In 98% of the enrolled patients, the EEG data were of sufficient quality for analysis.
- The median onset-to-EEG time, EEG setup time, and EEG duration were 266 minutes, 5 minutes, and 185 seconds, respectively.
- The pairwise derived Brain Symmetry Index (pdBSI) reached the highest diagnostic accuracy for LVO-a stroke detection in the theta frequency band (area under the receiver operating characteristic curve, 0.90; sensitivity, 86%; specificity, 83%).
"Even though the electrodes in our subhairline EEG setup only covered a small part of the anterior and middle cerebral artery vascular territory, we were able to accurately detect LVO-a stroke with comparable or better diagnostic accuracy than studies using EEG electrodes more adequately covering these vascular territories," wrote the authors.
SOURCE:
The study was conducted by the first author Eva A. Groenendijk, MSc, the Department of Clinical Neurophysiology, Amsterdam UMC, University of Amsterdam, the Netherlands, and colleagues. The study was published online in the Journal of the American Heart Association onNovember 20, 2023.
LIMITATIONS:
- Study results cannot be directly applied to the prehospital setting.
- There was no correlation between the pdBSI in the theta frequency band and National Institutes of Health Stroke Scale score.
DISCLOSURES:
This study was funded by the Dutch Heart Foundation, Health~Holland, and an unrestricted research grant from Medtronic. H.A. Marquering, J.M. Coutinho, and W.V. Potters declared being cofounders and shareholders of Nicolab and TrianecT. J.M. Coutinho declared receiving research support from the Dutch Heart Foundation and Medtronic and unrelated research support from Bayer and Boehringer.
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