Neurological Sciences

, Volume 34, Issue 5, pp 671–678

Prognostic value of electroencephalography and evoked potentials in the early course of malignant middle cerebral artery infarction

  • Lothar Burghaus
  • Wei-Chi Liu
  • Christian Dohmen
  • Walter F. Haupt
  • Gereon R. Fink
  • Carsten Eggers
Original Article


Space-occupying brain edema may lead to a malignant course in patients with large middle cerebral artery infarction. Decompressive hemicraniectomy has to be initiated early to prevent further tissue damage. In this retrospective study, we analyzed electroencephalography (EEG) and evoked potentials (EPs), obtained within 24 h after onset of stroke, in 22 patients suffering from a large middle cerebral artery infarction. Our findings indicate a prognostic value of EEG and brainstem auditory EP (BAEP): the absence of delta activity and the presence of theta and fast beta frequencies within EEG-focus predicted a non-malignant course. In contrast, diffuse generalized slowing and slow delta activity in the ischemic hemisphere pointed to a malignant course. Likewise, pathological BAEP were correlated with a malignant course. The coexistence of background slowing and pathological BAEP showed the highest level of significance. In conclusion, our findings implicate an additional early application of electrophysiological methods in stroke patients. EEG and EP deliver useful information to select those patients who develop malignant edema.


Electroencephalography Evoked potentials Stroke Hemicraniectomy 


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Lothar Burghaus
    • 1
  • Wei-Chi Liu
    • 1
  • Christian Dohmen
    • 1
  • Walter F. Haupt
    • 1
  • Gereon R. Fink
    • 1
    • 2
  • Carsten Eggers
    • 1
  1. 1.Department of NeurologyUniversity Hospital CologneCologneGermany
  2. 2.Cognitive Neurology SectionInstitute of Neuroscience and Medicine (INM3), Research Centre JuelichJülichGermany

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