VALUE OF EEG IN COMPARISON TO SPECT AND C CT IN EARLY ISCHEMIC STROKE

To determine the sensitivity and clinical value of different diagnosti c tools (CCT, EEG and SPECT) in patients with acute ischemic stroke. T he subjects were 80 unselected patients with acute supratentorial cere bral ischemia. 25 patients suffered from TIAs, 19 patients from lacuna r infarction and 36 patients from watershed, terminal and territorial infarction. In the first 36 hours after the onset of symptoms, CCT (n= 80), EEG (n=79) and SPECT (n=64) procedures were performed. A second C CT was undertaken in 70 cases 3 or 4 days later to demonstrate potenti al substantial lesion. The sensitivities of the methods for the recogn ition of a lateralized hemispheric disorder were evaluated and statist ically compared. In large cortical infarctions (watershed, terminal or territorial infarction) the cerebral dysfunction was recognised in 10 0% of cases by EEG and SPECT. In lacunar infarction EEG demonstrated p athologic abnormalities in 73.7% and SPECT in 52.6%. In TIAs EEG revea led abnormalities in 41.7% and SPECT only in 9.5%; these differences w ere statistically significant (Me Nemar test; p- 0,0309). Zed CCT was goldstandard (sensitivity 100%) for the evaluation of a substantial le sion in lacunar and large cortical infarction. In TIAs and lacunar inf arction EEG is superior to SPECT for the recognition of a lateralized supratentorial cerebral ischemia. In large cortical infarction both me thods show equal sensitivities. In the early phase of cerebral ischemi a both methods are able to demonstrate cerebral disorder at a time whe n CCT is mostly unremarkable. SPECT seems to differentia more precisel y in the early phase between minor and major stroke consequences.