Cerebral Glucose and Spreading Depolarization in Patients with Aneurysmal Subarachnoid Hemorrhage

摘要: The pathogenesis of delayed cerebral ischemia (DCI) is multifactorial and not completely elucidated. Our objective was to determine if episodes spreading depolarization (SD) are reflected in compromised levels extracellular glucose monitored by bedside microdialysis (MD) aneurysmal subarachnoid hemorrhage (aSAH) patients. Patients with aSAH, prospectively included the COSBID (CoOperative Study on Brain Injury Depolarisations) protocol (Berlin, Heidelberg), had hourly monitoring MD parallel electrocorticographic (ECoG) for SD detection day admission until days 10–14 after aSAH. Cerebral probes were placed vascular territory at risk DCI. Twenty-one aSAH patients (53.3 ± 9.1 years; mean standard deviation), classified according World Federation Neurosurgical Societies (WFNS) low (I–III, 11) high (IV–V, 10) grades, studied. Of these, 13 (62%) presented Median 1.48 (0.00–8.79). occurrence 7 (0–66)/patients. High WFNS grade (WFNS grades IV–V) more SDs (p = 0.027), while overall level did differ. In high-grade SAH patients, frequent. Individually, linked local deviations (neither nor low) from LOWESS (locally weighted scatterplot smoothing) trend curve concentrations. Rapid-sampling techniques analyses clusters may elucidate detail relationship between brain energy metabolism.