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Neurological outcome prediction of comatose patients after cardiac arrest based on EEG, brain MRI and optic nerve ultrasonography

Verhulst, Marlous (2020) Neurological outcome prediction of comatose patients after cardiac arrest based on EEG, brain MRI and optic nerve ultrasonography.

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Abstract:Objective: To investigate the additional value of MRI measures, in addition to the EEG, to predict neurological outcome of comatose patients after cardiac arrest and to estimate potential value of repetititive ONSD measurements to further improve outcome prediction. Methods: We included comatose patients after cardiac arrest. EEGs were classified as unfavourable, favourable or intermediate. MRI scans at day 2-4 after cardiac arrest were visually (DWI, FLAIR) and quantitatively (ADC) assessed. ONSD was measured using ultrasound at day 1-3 after cardiac arrest. Predictive value for good and poor neurological outcome was assessed using ROC analyses. Results: 30 patients were included in MRI study (14 poor outcome). Cortex score predicted good outcome, DGN score predicted poor outcome best. Proportion of brain below 450x10^-6 mm^2/s on ADC map predicted good and poor outcome. EEG measures identified 21% of patients with poor outcome. MRI measures increased sensitivity to 86% at 100% specificity. 11 patients were included in ONSD study (6 poor outcome). No significant differences were found between patients with good and poor outcome at day 1-2. At day 3 patients with poor outcome had larger ONSD. Conclusion: Visual and quantitative MRI analyses hold potential to improve prediction of neurological outcome after cardiac arrest.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/80839
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