Abstract 241: Differentiating large vessel occlusion (LVO) acute ischemic stroke from LVO mimics using electro encephalography

• Published in: Stroke: vascular and interventional neurology 2024-11, Vol.4 (S1)
• Main Authors: Abbasi, M, Racz, F S, Millán, J R, Alawieh, H, Saber, H
• Format: Article
• Language: English
• Subjects: Asymmetry; Ischemia; Stroke; Symmetry
• ISSN: 2694-5746; 2694-5746
• DOI: 10.1161/SVIN.04.suppl_1.241

IntroductionLarge vessel occlusion (LVO) stroke is a leading cause of disability and death globally. Challenges remain in the timely diagnosis and transfer of patients with LVO stroke to endovascular‐capable centers. Leveraging recent non‐invasive Electro Encephalography (EEG) capabilities, we aimed to develop an algorithm that can quickly detect LVO strokes.MethodsIn this prospective study, we enrolled patients who presented with suspicion for stroke or whom code stroke was activated, including those with known LVO stroke transferred from other hospitals. Brain activity of eligible adults who were able to undergo EEG within three hours of arrival to the Emergency Department was collected from 19 standard scalp locations at 512 Hz sampling rate. EEG data were analyzed using advanced signal processing to distinguish LVO strokes from stroke mimics. Brain Symmetry Index (BSI) which measures inter‐hemispheric asymmetry on a whole‐head scale was considered as comparison parameter and a P value < 0.05 was considered statistically significant.ResultsThe final sample consisted of 46 patients (mean age: 64.13 years; 13 (28.2%) female) comprised of 12 patients with final diagnosis of LVO and 34 patients with LVO mimics as the etiology of their presentation. Study group demographics and clinical parameters are summarized in Table. From the collected EEG data, the Brain Symmetry Index (BSI) ‐ an established index characterizing inter‐hemispheric asymmetry on a whole‐head scale ‐ was estimated and compared between LVO and non‐LVO groups using a two‐sample t‐test. BSI was found increased in the LVO (0.2732±0.0932) compared to the non‐LVO (0.1948±0.0512) groups (p