2021
High epileptiform discharge burden predicts delayed cerebral ischemia after subarachnoid hemorrhage
Kim JA, Zheng WL, Elmer J, Jing J, Zafar SF, Ghanta M, Moura V, Gilmore EJ, Hirsch LJ, Patel A, Rosenthal E, Westover MB. High epileptiform discharge burden predicts delayed cerebral ischemia after subarachnoid hemorrhage. Clinical Neurophysiology 2021, 141: 139-146. PMID: 33812771, PMCID: PMC8429508, DOI: 10.1016/j.clinph.2021.01.022.Peer-Reviewed Original ResearchConceptsED burdenSubarachnoid hemorrhageEpileptiform dischargesCerebral ischemiaSAH patientsHigh riskOnset of DCIMajor risk periodContinuous EEG recordingsDCI patientsDCI riskRetrospective analysisNovel biomarkersGroup-based trajectory analysisRisk periodPatientsDay 3.5DCIBurdenHemorrhageIschemiaRiskEEG recordingsBurden rateUseful parameter
2020
Validation of the 2HELPS2B Seizure Risk Score in Acute Brain Injury Patients
Moffet EW, Subramaniam T, Hirsch LJ, Gilmore EJ, Lee JW, Rodriguez-Ruiz AA, Haider HA, Dhakar MB, Jadeja N, Osman G, Gaspard N, Struck AF. Validation of the 2HELPS2B Seizure Risk Score in Acute Brain Injury Patients. Neurocritical Care 2020, 33: 701-707. PMID: 32107733, DOI: 10.1007/s12028-020-00939-x.Peer-Reviewed Original ResearchConceptsAcute brain injuryClinical factorsContinuous EEG monitoringTraumatic brain injurySeizure incidenceEEG findingsClinical seizuresPrimary outcomeSubdural hematomaBrain injuryEEG monitoringAcute brain injury patientsRisk of seizuresBrain injury patientsReceiver operator characteristic curveOperator characteristic curveABI patientsPatient ageHospitalized patientsElectrographic seizuresInjury patientsIntraparenchymal hemorrhageClinical findingsSubarachnoid hemorrhageResultsA total
2013
Nonconvulsive seizures after subarachnoid hemorrhage: Multimodal detection and outcomes
Claassen J, Perotte A, Albers D, Kleinberg S, Schmidt JM, Tu B, Badjatia N, Lantigua H, Hirsch LJ, Mayer SA, Connolly ES, Hripcsak G. Nonconvulsive seizures after subarachnoid hemorrhage: Multimodal detection and outcomes. Annals Of Neurology 2013, 74: 53-64. PMID: 23813945, PMCID: PMC3775941, DOI: 10.1002/ana.23859.Peer-Reviewed Original ResearchConceptsRegional cerebral blood flowAcute brain injuryBrain injuryCerebral physiologic effectsCerebral perfusion pressureSecondary brain injuryBrain tissue oxygenationSubarachnoid hemorrhage patientsCerebral blood flowGlobal brain metabolismElevated heart rateComplex physiologic processBlood pressureNonconvulsive seizuresHemorrhage patientsPerfusion pressureSubarachnoid hemorrhageBrain metabolismFunctional outcomeIntracranial pressureSeizure onsetPhysiologic effectsHeart rateOnly seizuresBlood flow
2010
Intracortical EEG for the Detection of Vasospasm in Patients with Poor-Grade Subarachnoid Hemorrhage
Stuart RM, Waziri A, Weintraub D, Schmidt MJ, Fernandez L, Helbok R, Kurtz P, Lee K, Badjatia N, Emerson R, Mayer SA, Connolly ES, Hirsch LJ, Claassen J. Intracortical EEG for the Detection of Vasospasm in Patients with Poor-Grade Subarachnoid Hemorrhage. Neurocritical Care 2010, 13: 355-358. PMID: 20652443, DOI: 10.1007/s12028-010-9414-6.Peer-Reviewed Original ResearchConceptsPoor-grade SAH patientsAlpha/delta ratioDetection of vasospasmSAH patientsPoor-grade subarachnoid hemorrhageIntracortical electroencephalographyQuantitative EEG parametersQuantitative EEG analysisAngiographic confirmationAngiographic vasospasmSubarachnoid hemorrhageSustained decreaseVasospasmPatientsBaseline EEGPercent changeDepth electrodesQEEG recordingsLarger studySurface EEGDelta ratioIntracortical EEGEEG parametersAlarm criteriaBaselineSeizures and CNS Hemorrhage
Gilmore E, Choi HA, Hirsch LJ, Claassen J. Seizures and CNS Hemorrhage. The Neurologist 2010, 16: 165-175. PMID: 20445426, DOI: 10.1097/nrl.0b013e3181c7cd0b.Peer-Reviewed Original ResearchConceptsAneurysmal subarachnoid hemorrhageCentral nervous system hemorrhageShort-term prophylaxisNonconvulsive seizuresIntracerebral hemorrhageSpontaneous intracerebral hemorrhageSeizure prophylaxisASAH patientsAdditional injuriesAcute brain injuryPoor clinical gradeEvidence-based guidelinesCommon neurologic conditionsDeleterious effectsAntiepileptic medicationsControlled TrialsConvulsive seizuresCNS hemorrhagePoor outcomeSubarachnoid hemorrhageNeurologic conditionsSurrogate markerBrain injuryClinical gradeRecent injury
2009
Continuous Electroencephalogram Monitoring in the Intensive Care Unit
Friedman D, Claassen J, Hirsch LJ. Continuous Electroencephalogram Monitoring in the Intensive Care Unit. Anesthesia & Analgesia 2009, 109: 506-523. PMID: 19608827, DOI: 10.1213/ane.0b013e3181a9d8b5.Peer-Reviewed Original ResearchConceptsContinuous EEG monitoringNonconvulsive seizuresIll patientsIntracranial pressureBrain functionContinuous electroencephalogram monitoringConvulsive status epilepticusIntensive care unitMajority of seizuresMultimodality brain monitoringPharmacological comaNeurologic outcomeNeurologic statusNeuronal injuryBrain ischemiaStatus epilepticusCare unitSecondary injurySubarachnoid hemorrhageCEEG monitoringClinical examinationElectroencephalogram monitoringSystemic abnormalitiesIntracranial EEG recordingsHigh risk
2007
Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage: the nationwide inpatient sample.
Claassen J, Bateman BT, Willey JZ, Inati S, Hirsch LJ, Mayer SA, Sacco RL, Schumacher HC. Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage: the nationwide inpatient sample. Neurosurgery 2007, 61: 60-4; discussion 64-5. PMID: 17621019, DOI: 10.1227/01.neu.0000279724.05898.e7.Peer-Reviewed Original ResearchConceptsNontraumatic subarachnoid hemorrhageConvulsive status epilepticusNationwide Inpatient SampleSubarachnoid hemorrhageRenal diseaseStatus epilepticusInpatient SampleNonfederal United States hospitalsGeneralized convulsive status epilepticusDatabase of admissionsDuration of hospitalizationMultivariate logistic regressionUnited States hospitalsHospital mortalityHospital stayAdult patientsYounger patientsIndependent predictorsPatient mortalityEmergency departmentPatientsLinear regression analysisState HospitalNeurosurgical proceduresLogistic regression
2006
Prognostic significance of continuous EEG monitoring in patients with poor-grade subarachnoid hemorrhage
Claassen J, Hirsch LJ, Frontera JA, Fernandez A, Schmidt M, Kapinos G, Wittman J, Connolly ES, Emerson RG, Mayer SA. Prognostic significance of continuous EEG monitoring in patients with poor-grade subarachnoid hemorrhage. Neurocritical Care 2006, 4: 103-112. PMID: 16627897, DOI: 10.1385/ncc:4:2:103.Peer-Reviewed Original ResearchConceptsModified Rankin ScalePeriodic lateralized epileptiform dischargesSubarachnoid hemorrhageHess gradePoor outcomeEEG findingsCEEG monitoringEpileptiform dischargesPoor-grade subarachnoid hemorrhageMultivariate logistic regression analysisAdmission CT scanPeriodic epileptiform dischargesLogistic regression analysisRankin ScaleIll patientsIntraventricular hemorrhageMRS 4Functional outcomeSleep architectureEEG reactivityCT scanPatientsOutcomesHemorrhageRegression analysis
2005
Continuous EEG Monitoring in Patients With Subarachnoid Hemorrhage
Claassen J, Mayer SA, Hirsch LJ. Continuous EEG Monitoring in Patients With Subarachnoid Hemorrhage. Journal Of Clinical Neurophysiology 2005, 22: 92-98. PMID: 15805808, DOI: 10.1097/01.wnp.0000145006.02048.3a.Peer-Reviewed Original ResearchConceptsContinuous EEG monitoringSubarachnoid hemorrhageEEG monitoringPoor-grade subarachnoid hemorrhageAdditional diagnostic interventionsQuantitative EEG analysisCEEG findingsCerebral ischemiaNeurological examComatose patientsSAH patientsCEEG monitoringClinical correlatesDiagnostic interventionsClinical examPatientsEEG changesIschemiaSeizuresReversible stageVasospasmHemorrhageRiskLimited utilityEEG analysis
2004
Quantitative continuous EEG for detecting delayed cerebral ischemia in patients with poor-grade subarachnoid hemorrhage
Claassen J, Hirsch LJ, Kreiter KT, Du EY, Connolly ES, Emerson RG, Mayer SA. Quantitative continuous EEG for detecting delayed cerebral ischemia in patients with poor-grade subarachnoid hemorrhage. Clinical Neurophysiology 2004, 115: 2699-2710. PMID: 15546778, DOI: 10.1016/j.clinph.2004.06.017.Peer-Reviewed Original ResearchConceptsPoor-grade subarachnoid hemorrhageDetection of DCISAH patientsSubarachnoid hemorrhageCerebral ischemiaQEEG parametersClinical examHunt-Hess grade 4Poor-grade SAH patientsPost-operative day 2Continuous EEG monitoringInitiation of interventionsAlpha/delta ratioQuantitative EEG parametersNeurological morbidityDCI patientsNeuro-ICUMedian decreasePatientsDay 1EEG monitoringDay 2Day 14Day 4Reasonable specificity
2002
Nonconvulsive Status Epilepticus after Subarachnoid Hemorrhage
Dennis LJ, Claassen J, Hirsch LJ, Emerson RG, Connolly ES, Mayer SA. Nonconvulsive Status Epilepticus after Subarachnoid Hemorrhage. Neurosurgery 2002, 51: 1136. PMID: 12383358, DOI: 10.1097/00006123-200211000-00006.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageCEEG monitoringUnexplained comaNeurological deteriorationStatus epilepticusRefractory nonconvulsive status epilepticusNeurological intensive care unitProphylactic anticonvulsant therapyHours of hospitalizationContinuous electroencephalographic monitoringIntensive care unitAnticonvulsant administrationHospital seizuresAnticonvulsant therapyCerebral edemaClinical improvementHess gradeCare unitClinical featuresComatose patientsElectrographic seizuresVentricular drainageMidazolam therapy