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Objective To explore the clinical application of quantitative electroencephalography (qEEG) in predicting the early prognosis of acute ischemic stroke after mechanical thrombectomy. Methods A total of 71 patients who underwent acute ischemic stroke mechanical thrombectomy from April 2021 to September 2022 were enrolled in He'nan Provincial People's Hospital, all of them performed qEEG after surgery. Modified Rankin Scale (mRS) was used to evaluate the prognosis on the 90 d after the surgery. Univariate and multivariate backward Logistic regression analyses were used to screen risk factors for prognosis in acute ischemic stroke after mechanical thrombectomy. Receiver operating characteristic (ROC) curve was used to predict the value of qEEG for the prognosis of neural function. Results Patients in dismal prognosis group (mRS score 3-5, n = 28) had higher NIHSS score at admission (t = 2.686, P = 0.009), higher proportion of thrombectomy performed more than 3 times (χ2 = 4.201, P = 0.040), higher values of DTABR on the affected side (t = 2.183, P = 0.032), higher ratio of DTABR on affected side/ unaffected side (t = 6.230, P = 0.000), and higher proportion of immediately Thrombolysis in Cerebral Infarction (TICI) < 2b after surgery (χ2 = 5.420, P = 0.020) compared to favorable prognosis group (mRS score 0-2, n = 43). Logistic regression analysis showed higher NIHSS score at admission (OR = 1.542, 95%CI: 1.368-1.725；P = 0.012), DTABR on affected side/unaffected side (OR = 3.428, 95%CI: 2.673-7.314; P = 0.008), percent alpha variability (PAV) grade Ⅱ (OR = 2.983, 95%CI: 2.625-4.682; P = 0.003) and grade Ⅲ (OR = 4.088, 95%CI: 3.825-5.349; P = 0.002), amplitude electroencephalography (aEEG) grade Ⅱ (OR = 2.536, 95%CI: 1.942-5.287; P = 0.005) and grade Ⅲ (OR = 3.924, 95%CI: 2.012-6.378; P = 0.003) were risk factors of dismal prognosis in acute ischemic stroke after mechanical thrombectomy. ROC curve showed the area under the curve (AUC) of NIHSS score was 0.676 (95%CI: 0.554-0.782, P = 0.000), DTABR on affected side/unaffected side was 0.887 (95%CI: 0.789-0.950, P = 0.000), the PAV was 0.760 (95%CI: 0.643-0.853, P = 0.000), aEEG was 0.778 (95%CI: 0.664-0.868, P = 0.000), and the combined indicators classification was 0.943 (95%CI: 0.861-0.984, P = 0.000). Among them, the predictive power of the combined indicators is higher than that of the NIHSS score at admission (Z = 4.150, P = 0.000), PAV (Z = 4.006, P = 0.000) and aEEG (Z = 3.462, P = 0.001). Conclusions qEEG is an effective method to predict the early prognosis of acute ischemic stroke after mechanical thrombectomy.

doi：10.3969/j.issn.1672⁃6731.2021.12.014

Objective To evaluate the clinical value of bedside ultrasound measurement of optic nervesheath diameter (ONSD) in the prognosis of severe traumatic brainin jury (sTBI). Methods Atotal of 78 sTBI patients admitted to Department of Neurosurgery ICU of He'nan Provincial People's Hospital from April 2017 to April 2019 were enrolled. Intracranial pressure (ICP) monitoring probe was placed when the patient was admitted, and bedside ultrasound was used to detect the ONSD. The values of ONSD in supine position and 30° head⁃up position, 30min before and after ventilation, and 30min before and after mannitol treatment were observed and analyzed. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of ONSD for unfavourable prognosis of sTBI patients. Results The mean ICP in unfavourable prognosis group [Glasgow Outcome Scale (GOS) score 1-3] was higher than that in favourable prognosis group (GOS score 4-5; t=2.111, P=0.038). After 30° head⁃up position, 30 min after ventilation and mannitol treatment, the values of ONSD were lower than supine position (F=6.644, P= 0.012),and30 min befor eventilation (F=4.492, P=0.037) and mannitol treatment (F=5.552, P=0.021), and ONSD in unfavourable prognosis group were higher than those in favourable prognosis group (posture change: F=16.751, P=0.000; ventilation treatment: F=29.776, P=0.000; application of mannitol: F= 12.465, P=0.002). There was a positive correlation between ONSD and ICP (r=0.691, P=0.000). ONSD at 5.53 mm was the optimal threshold for unfavourable prognosis, the area under the curve (AUC) was 0.776 (95%CI: 0.826-0.978, P =0.000). The sensitivity was 91.52% and the specificity was 87.14%. Conclusions Dynamic detection of ONSD by bedside ultrasound is helpful to evaluate the prognosis of sTBI, and guide the precise treatment of severe ICP. DOI：10.3969/j.issn.1672⁃6731.2020.08.006