Clinical Study On Application Of Brainstem Auditory Evoked Potential (BAEP) In Neurosurgery

Part I Clinical study on application of BAEP in craniocerebral traumaObjective By making diagnosis and giving treatment and follow-up, we tried to explore the relationship between BAEP changes and damage levels, prognosis of patients with acute craniocerebral trauma; the relationship between dynamic BAEP monitoring results and patient's conditions; the BAEP changes and clinical significance on brain death of patients with craniocerebral trauma; the correlation between BAEP and electroencephalogram of patients at the early period with severe craniocerebral trauma.Methods There were 73 patients(146 ears)aged from 15 to 55 with acute craniocerebral trauma in our hospital from July, 2007 to January, 2009, and there were 34 healthy volunteers(68 ears) aged from 21 to 46 with normal audition. Their data were collected and analyzed and the data from volunteers was used as the reference value. (1) The damage level of patients was evaluated by Glasgow Coma Score (GCS). Based on GCS, these patients were divided into three groups:①Mild head injury: GCS was between 13～15;②Moderate head injury: GCS was between 9～12;③Severe head injury: GCS was between 3～8. All the patients received BAEP examination during the first three days after injury. With contrast to the reference value from the volunteers and according to diagnostic standards by Greenberg which is including 4 grades:Ⅰ-Ⅳdegrees, the relationship between damage level of patients with acute craniocerebral trauma and BAEP changes were studied. (2) All the patients received BAEP examination in three time points: the first three days after injury; one week after injury; one month after injury. Their BAEP fluctuating changes were observed. After three to six months of follow-up studies, the patients, based on their GOS, were divided into two groups: prognosis of favorable outcome (GOS: 4-5); prognosis of poor outcome (GOS: 1-3). The relationship between different levels of abnormal BAEP changes in patients with acute craniocerebral trauma with different time point and their prognosis was studied. (3) The relationship between early wave disappearance in BAEP and clinical brain death of the patients with acute craniocerebral trauma was observed.(4)The correlation between BAEP and electroencephalogram of the patients at the early period with severe craniocerebral trauma was studied.Results (1) There were positive correlation and linear relationship between the damage level of patients with acute craniocerebral trauma and their grades of early BAEP changes (χ2regression = 21.518 , P<0.005 ;χ2bias =3.291,0.5