Spreading depression in continuous electroencephalography of brain trauma.

摘要: Objective Cortical spreading depolarizations are a pathophysiological mechanism and candidate target for advanced monitoring in acute brain injury. Here we investigated manifestations of depolarization continuous electroencephalography (EEG) as broadly applicable, noninvasive method neuromonitoring. Methods Eighteen patients requiring surgical treatment traumatic injury were monitored by invasive electrocorticography (ECoG; subdural electrodes) scalp EEG during intensive care. Spreading first identified recordings, was then examined visually quantitatively to identify correlates. Results A total 455 occurred 65.9 days simultaneous ECoG/EEG monitoring. For 179 events (39%), caused temporally isolated, transient depressions spontaneous amplitudes 57% (median) baseline power. Depressions lasted 21 minutes suppressions high-amplitude delta activity present pattern the injured hemisphere. 62 (35%) events, isolated showed clear spread depression between channels with delays 17 (median), sometimes spanning entire A further 188 (41%) associated that hours due ongoing depolarizations. Depolarizations also evidenced shifts direct current potentials. Interpretation Leao's can be observed clinically standard, EEG, underlying widely across cerebral These results open possibility noninvasively neuronal wide range disorders including ischemic stroke, subarachnoid hemorrhage, trauma, suggest novel application EEG. Ann Neurol 2014;76:681–694