Central relative beta power recorded approximately 24 h after endovascular treatment was independently associated with 90-day futile recanalization and showed potential incremental prognostic value, with exploratory QEEG links to postoperative complications suggesting a non-invasive bedside "brain window" for neurocritical care.
55.4% of patients with AIS-LVO in this cohort developed 90-day futile recanalization despite successful endovascular treatment.
Higher central relative beta power was independently associated with lower odds of 90-day futile recanalization.
Adding central beta power to the clinical model improved prediction of futile recanalization in cross-validation.
Delta-band Brain Symmetry Index tracked parenchymal hemorrhage in exploratory analyses.
Exploratory graph analysis showed macro-scale network disintegration in patients with futile recanalization.
The QEEG features showed high split-half reliability.
The authors conclude that QEEG may serve as a non-invasive bedside 'brain window' for neurocritical care after endovascular treatment.
After a stroke caused by a blocked large brain artery, doctors can often remove the clot and reopen the vessel, yet about half of patients still do poorly at 90 days. This study looked at whether a short brain-wave (EEG) recording taken about a day after the procedure could help identify who is at higher risk of this 'futile' outcome. It included 56 patients, and 31 of them (55%) had a futile recanalization. The researchers found that patients with higher beta-wave activity in the central part of the brain had lower odds of a poor outcome, even after accounting for other clinical factors. Adding this measure to a model based on standard clinical information improved prediction accuracy in internal testing. In exploratory analyses, a measure of asymmetry between brain hemispheres in delta waves was linked to brain bleeding, and patients with poor outcomes showed signs of disrupted brain network connectivity. The EEG measures were also consistent when calculated from different halves of the recording. This research suggests that a bedside EEG could eventually offer a non-invasive way to monitor recovery after stroke treatment. However, the study was small, came from a single center, and was retrospective, and some analyses were exploratory, so the findings would need confirmation in larger studies before they could be used in practice.
Cai J, Xue F, Zhao Z, Chen H. (2026). Early Post-Operative Quantitative EEG Central Beta Power Predicts Futile Recanalization After Endovascular Treatment in AIS-LVO.. CNS neuroscience & therapeutics. https://doi.org/10.1002/cns.71228