engleski

Doppler sonography and EEG in cerebrovascular disease

The electroencephalography (EEG) is a method that cannot be avoided in the routine work in the majority of neurologic diseases. Therefore, it is present in the treatment of neurologic patients with extracranial and intracranial flow disturbances. The acute cerebrovascular disease are usually accompanied by EEG abnormalities. However, this changes need not be specific. The focus of slow waves, suggesting the cortical damage, is often met. Because a great part of strokes occurs at the site of irrigation of the a.cerebri media, the findings of changed waves ower the temporal region are often observed. Homolateral frequency retardation over the wall hemisphere can be found and focal peaks are also frequent. Activity retardations over the whole equilateral hemisphere are most frequently described in the extracranial flow disturbances. No doubt, more precise diagnosis in the sense of etiology of the process and very often of the localization cannot be made for certain because of varied EEG findings. Contrary, Doppler sonography is very reliable method for diagnostics of extracranial carotid flow disturbances, being in accordance with angiographic investigations. Negative or minimally changed EEG findings were conspicuous phenomena with our examined patients in the cases of Doppler sonographycally outstanding flow disturbances, which were angiographically confirmed. In the majority of cases it was the question of asymptomatic forms, oligosymptomatic or atypical disturbances. The EEG was somewhat more sensitive in cases of TIA and RIND. Negative EEG or minimal alteration in these cases are certainly explained by the establishment of collateral flow, owing to which the brain infarct was avoided. The EEG findings were more pathognomonic in the intracranial flow disturbances, in the sense of definite thromboses. However, Doppler sonography pointed to asymmetry in the smaller number of cases. Therefore the authors concluded that the Doppler sonographic analysis should be performed, first of all, in all risk groups as a method of choice for the extracranial carotid flow disturbances. In cases of TIA and RIND, independently of regular EEG findings, and if Doppler sonography suggests a flow disturbance, angiographic treatment is to be performed. Namely, negative EEG finding does not exclude a serious affection of flow through the exracranial part of the carotid confluence. According to our experience, if there was a serious alteration of findings on the EEG, especially in the sense of rhythm retardation ower the whole hemisfere, it had been, a bed prognostic sign. Angiography revealed occlusions of the neck carotid artheries with clinically usually massive hemiplegia and severe disability.

Doppler sonography; electroencephalography; cerebrovascular disease

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