title: Continuous electroencephalography (cEEG) changes precede clinical changes in a case of progressive cerebral edema.
abstract: BACKGROUND
  Continuous electroencephalogram (cEEG) is tightly linked to cerebral metabolism and is sensitive to cerebral ischemia and hypoxia. The severity of cerebral ischemia can be seen on cEEG as changes in morphology, amplitude, or frequency, and cEEG may detect neuronal dysfunction at a reversible stage.
  
  
  METHODS
  Case report and imaging.
  
  
  RESULTS
  We present a case of focal cerebral edema with changes seen on cEEG 24 h before clinical signs of increased intracranial pressure. cEEG showed developing asymmetry in the left hemisphere followed by burst suppression. The right hemisphere showed similar progression to burst suppression. Complete suppression of both hemispheres was noted 6 h before clinical signs of herniation. Computed tomography (CT) head confirmed a large left parietal intracerebral hematoma with mass effect.
  
  
  CONCLUSIONS
  cEEG has applications in monitoring cerebral dysfunction in addition to detecting seizure activity in the intensive care unit. It may serve a vital role in multi-modality monitoring for early recognition of neurological complications from brain injuries that may not be noticed clinically, which is paramount to early intervention.
authors: Department of Adult Neurology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195-5245, USA.
authors: C R
authors: CR
authors: Newey
authors: A
authors: A
authors: Sarwal
authors: S
authors: S
authors: Hantus
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D001929:Brain Edema / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D018450:Disease Progression; D004569:Electroencephalography / Q000379:methods*; D004677:Encephalocele / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D017809:Fatal Outcome; D006406:Hematoma / Q000150:complications / Q000473:pathology; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D010296:Parietal Lobe / Q000473:pathology / Q000503:physiopathology; D011379:Prognosis; D013226:Status Epilepticus / Q000188:drug therapy / Q000209:etiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000927:Anticonvulsants