To explore the relationship between electroencephalogram (EEG) parameters combined with inflammatory index and cerebral edema after acute ischemic stroke due to anterior circulation large vessel occlusion (AIS-LVO) surgery.

A total of 120 patients with AIS-LVO admitted to Function Department of Handan Central Hospital from October 2022 to December 2023 were selected and divided into the cerebral edema group and the non-cerebral edema group according to whether cerebral edema occurred after mechanical thrombectomy. The basic data of the two groups were statistically analyzed. Quantitative EEG examinations were performed with a digital EEG monitoring system to calculate the (δ+θ)/(α+β) ratio (DTABR) and δ-to-α ratio (DAR). Blood samples were collected to measure laboratory indicators and the systemic immunoinflammatory index (SII) and C-reactive protein-albumin-lymphocyte (CALLY) index were calculated. The clinical data of the two groups were analyzed. The influencing factors of cerebral edema after mechanical thrombectomy were analyzed using the multivariate Logistic regression model. A risk nomogram was constructed based on the above influencing factors, and the model fit was verified and the predictive efficacy was evaluated.

There were 55 patients in the cerebral edema group and 65 patients in the non-cerebral edema group. There were significant differences in the excellent conditions of collateral circulation, SII, CALLY index, and quantitative electroencephalogram parameters between the two groups (P<0.05). The multivariate Logistic regression model showed that SII index, DTABR, and DAR were risk factors for cerebral edema after mechanical thrombectomy in patients with AIS-LVO, while CALLY index was a protective factor (P<0.05). A nomogram prediction model for the risk of postoperative cerebral edema was constructed based on the four independent influencing factors above. Internal validation revealed favorable goodness-of-fit of the model. The area under the receiver operating characteristic curve was 0.871 (95%CI: 0.812-0.917, P<0.05). The sensitivity, specificity and Youden's index were 93.02%, 72.52% and 0.628 respectively, which demonstrated that this nomogram possessed satisfactory predictive performance for clinical application.

Quantitative electroencephalogram parameters and SII are risk factors for cerebral edema after mechanical thrombectomy in patients with AIS-LVO, and CALLY index is a protective factor. The risk prediction model constructed based on this has a high predictive efficacy.