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121 Introduction: Serial changes in cerebral blood  flow after intracerebral hemorrhage may influence tissue viability in  regions surrounding the hematoma. Non invasive monitoring may assist  titration of systolic blood pressure. Purpose: To determine if  continuous quantitative electroencephalography percent alpha  variability(EEGPAV)can discriminate areas of critically reduced  cerebral blood flow (CBF).Methods: Ten patients with  traumatic intracerebral hemorrhage underwent combined monitoring of  cerebral microdialysis, EEGPAV, and intermittent xenon-computerized  tomograhpy to determine if EEGPAV monitoring could determine and  monitor cellular distress in the context of oligemia. Critical oligemia  was defined as CBF &lt; 25. Time and regional matched samples of  EEG, microdialysis and CBF were used to correlate across modalities.  Regions adjacent to the hematoma only were studied.Results: Six patients had regional CBF   30 cc/100gm/min. In the low CBF group, the mean regional EEGPAV was  0.11 ± 0.4 compared to 0.22 ± 0.3 in the high-normal CBF  group(p &lt; 0.01). The low CBF group had lower extracellular levels  of glucose (0.33±0.27) compared to the high-normal CBF group  (1.9±1.0) (p &lt; 0.001). Extracellular glutamate levels were  higher in the low CBF group (14.5 ±23 uM) compared to the high-normal  CBF group (1.34±0.8) (p &lt; 0.001). Lactate and glycerol levels  were not statistically different between groups (p &lt; 0.8)Conclusion: EEGPAV can discriminate brain regions that have  critical oligemia and neurochemichal evidence of cellular  distress.

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Detection of critical oligemia in patients with traumatic intracerebral hemorrhage using continuous quantitative electroencephalography and cerebral microdialysis