Quantitative Electroencephalography Monitoring in Type A Aortic Dissection Surgery: A Clinical Case Review and Prospective Applications

• Published in: Brain and behavior Vol. 14; no. 10; pp. e70086 - n/a
• Main Authors: Wang, Ya‐Peng, Qu, Jason Z., Wang, Dong‐Jin
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.10.2024; John Wiley and Sons Inc; Wiley
• Subjects: Anesthesia; Aortic Aneurysm - physiopathology; Aortic Aneurysm - surgery; Aortic dissection; Aortic Dissection - physiopathology; Aortic Dissection - surgery; Asymmetry; Bandwidths; Brain - physiopathology; Brain - surgery; brain function; Coma; Consciousness; Contraindications; Electroencephalography; Electroencephalography - methods; Fainting; Humans; Ischemia; Male; Medical prognosis; Patients; quantitative electroencephalography; Review; Surgery; Transient ischemic attack; Traumatic brain injury; aortic dissection; brain function; quantitative electroencephalography
• ISSN: 2162-3279; 2162-3279
• DOI: 10.1002/brb3.70086

ABSTRACT Purpose This review explores advanced methods for assessing perioperative cerebral function in Type A aortic dissection (TAAD) patients, with a focus on quantitative electroencephalography (QEEG). It highlights the critical issue of cerebral malperfusion, which is associated with higher mortality and poor prognosis during the perioperative phase in TAAD patients. Method The review centers on the utilization of QEEG as a pivotal tool for the extensive monitoring of brain function at various stages: preoperatively, intraoperatively, and postoperatively. It elaborates on the foundational principles of QEEG, including the mathematical and computational analysis of electroencephalographic signals, enriched with intuitive graphical representations of cerebral functional states. Finding QEEG is presented as an innovative approach for the real‐time, noninvasive, and reliable assessment of cerebral function. The review details the application of QEEG in monitoring conditions such as preoperative cerebral malperfusion, intraoperative deep hypothermic circulatory arrest, and postoperative recovery of cerebral function in patients undergoing TAAD treatment. Conclusion Although QEEG is still in an exploratory phase for TAAD patients, it has shown efficacy in other domains, suggesting its potential in multimodal brain function monitoring. However, its broader application requires further research and technological advancements. The crux of perioperative monitoring of TAAD lies in the continuous assessment of central nervous system function, which can be achieved through a multimodal approach encompassing NIRS for monitoring oxygen delivery, QEEG for evaluating neurological function, and TCD for assessing blood flow, with QEEG potentially aiding in the early detection of neurological abnormalities, though further research and development is warranted in this regard.