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Electroencephalography Might Improve Diagnosis of Acute Stroke and Large Vessel Occlusion
Journal article   Open access   Peer reviewed

Electroencephalography Might Improve Diagnosis of Acute Stroke and Large Vessel Occlusion

Fareshte Erani, Nadezhda Zolotova, Benjamin Vanderschelden, Nima Khoshab, Hagop Sarian, Laila Nazarzai, Jennifer Wu, Bharath Chakravarthy, Wirachin Hoonpongsimanont, Wengui Yu, …
Stroke (1970), v 51(11), pp 3361-3365
01 Nov 2020
PMID: 32942967
url
https://doi.org/10.1161/strokeaha.120.030150View
Published, Version of Record (VoR)Open Access (License Unspecified) Open
url
https://doi.org/10.1161/STROKEAHA.120.030150View
Published, Version of Record (VoR) Open

Abstract

Cardiovascular System & Cardiology Clinical Neurology Life Sciences & Biomedicine Neurosciences & Neurology Peripheral Vascular Disease Science & Technology
Background and Purpose: Clinical methods have incomplete diagnostic value for early diagnosis of acute stroke and large vessel occlusion (LVO). Electroencephalography is rapidly sensitive to brain ischemia. This study examined the diagnostic utility of electroencephalography for acute stroke/transient ischemic attack (TIA) and for LVO. Methods: Patients (n=100) with suspected acute stroke in an emergency department underwent clinical exam then electroencephalography using a dry-electrode system. Four models classified patients, first as acute stroke/TIA or not, then as acute stroke with LVO or not: (1) clinical data, (2) electroencephalography data, (3) clinical+electroencephalography data using logistic regression, and (4) clinical+electroencephalography data using a deep learning neural network. Each model used a training set of 60 randomly selected patients, then was validated in an independent cohort of 40 new patients. Results: Of 100 patients, 63 had a stroke (43 ischemic/7 hemorrhagic) or TIA (13). For classifying patients as stroke/TIA or not, the clinical data model had area under the curve=62.3, whereas clinical+electroencephalography using deep learning neural network model had area under the curve=87.8. Results were comparable for classifying patients as stroke with LVO or not. Conclusions: Adding electroencephalography data to clinical measures improves diagnosis of acute stroke/TIA and of acute stroke with LVO. Rapid acquisition of dry-lead electroencephalography is feasible in the emergency department and merits prehospital evaluation.

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Web of Science research areas
Clinical Neurology
Peripheral Vascular Disease
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