Serdar ÖZDEMİR, Tuba CİMİLLİ, Özge Ecmel ONUR

Relationship between the National Institutes Health Stroke Scale Score and Bispectral Index in Patients with Acute Ischemic Stroke

Objective: This study aimed to investigate the relationship between the bispectral index and the National Institutes of Health Stroke Scale (NIHSS) score in patients admitted to the emergency department with a first-time acute ischemic stroke. Methods: This prospective, observational study was conducted with patients admitted to our clinic with acute ischemic stroke symptoms. Patients with known cranial pathologies, such as space-occupying lesions, those with a history of clinically significant cerebrovascular events or sedative drug administration, and those with altered consciousness due to metabolic causes were excluded from the study. The National Institutes Health Stroke Scale scores were recorded by the clinician. Cerebral arterial territories were assessed on DWI and CT. The relationship between the NIHSS score and bispectral index was evaluated. Results: Forty-three patients were included in the study. The mean bispectral index of the cases was 84.23 ± 9.50. There was no significant correlation between the bispectral index values and the NIHSS score (p

Keywords:

Consciousness, Consciousness Monitors Ischemic Stroke, Physical Examination, Stroke,

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1. Lloyd-Jones DM, Hong Y, Labarthe D et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goalthrough 2020 and beyond. Circulation. 2011;121:586-613.
2. Heldner MR, Zubler C, Mattle HP et al. National Institutes of Health stroke scale score and vessel occlusion in 2152 patients with acute ischemic stroke. Stroke. 2013;44:1153-7.
3. Arbour R. Continuous nervous system monitoring, EEG, the bispectral index, and neuromuscular transmission. AACN ClinIssues. 2003;14:185-207.
4. Guerrier G, Gianni MA. Bispectral index versus standard monitoring in sedation for endoscopic procedures: a systematic review and meta-analysis. J Clin Anesth. 2019;58:100-4.
5. Ortiz GA, Sacco RL. National Institutes of Health Stroke Scale (NIHSS). Wiley Encyclopedia of Clinical Trials. 2008.
6. Agrawal D, Feldman HA, Krauss B, et al. Bispectral index monitoring quantifies depth of sedation during emergency department procedural sedation and analgesia in children. Ann Emerg Med. 2004;43:247-55.
7. Barbato M, Barclay G, Potter J, et al. Correlation between observational scales of sedation and comfort and Bispectral Index scores (BIS). J Pain Symptom Manag. 2017;54:186-93.
8. Kusken O, Ozturk TC, Hunuk A, et al. Relationship between brain computed tomography findings and bispectral index score in patients presenting with head trauma. North Clin Istanb. 2019;6:219–25.
9. Morimoto Y, Monden Y, Ohtake K, et al. The detection of cerebral hypoperfusion with bispectral index monitoring during general anesthesia. Anesth Analg. 2005;100:161.
10. Welsby IJ, Ryan JM, Booth JV, et al. The bispectral index in the diagnosis of perioperative stroke: a case report and discussion. Anesth Analg. 2003;96:435-7.
11. Leggat CS1, Fischer GW. Early detection of an acute cerebral event during cardiopulmonary bypass using a bispectral index monitor. Semin Cardiothorac Vasc Anesth. 2008;12:80-2.
12. Villacorta J, Kerbaul F, Collart F, et al. Perioperative cerebral ischaemia in cardiac surgery and BIS. Anaesth Intensive Care. 2005;33:514-7.
13. Deogaonkar A, Vivar R, Bullock RE, et al. Bispectral index monitoring may not reliably indicate cerebral ischaemia during awake carotid endarterectomy. Br J Anaesth. 2005;94:800–4.
14. Kovalzon VM. Ascending reticular activating system of the brain. Transl Neurosci Clin. 2016;2:275–85.
15. Ott T, Nieder A. Dopamine and cognitive control in prefrontal cortex. Trends Cogn Sci. 2019;23(3):213–34.