• Medicina intensiva · Oct 2014

    Observational Study

    Cortical spreading depolarization phenomena in patients with traumatic and ischemic brain injuries. Results of a pilot study.

    • M Sueiras, J Sahuquillo, B García-López, Á Sánchez-Guerrero, M A Poca, E Santamarina, M Riveiro, M Fabricius, and A J Strong.
    • Servicio de Neurofisiología, Hospital Universitario Vall d'Hebron, Barcelona, España; Unidad de Investigación de Neurotraumatología y Neurocirugía (UNINN), Hospital Universitario Vall d'Hebron, Institut Fundació de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
    • Med Intensiva. 2014 Oct 1; 38 (7): 413-21.

    ObjectivesTo determine the frequency and duration of cortical spreading depolarization (CSD) and CSD-like episodes in patients with traumatic brain injury (TBI) and malignant middle cerebral artery infarction (MMCAI) requiring craniotomy.DesignA descriptive observational study was carried out during 19 months.SettingNeurocritical patients.PatientsSixteen patients were included: 9 with MMCAI and 7 with moderate or severe TBI, requiring surgical treatment.InterventionsA 6-electrode subdural electrocorticographic (ECoG) strip was placed onto the perilesional cortex.Main Variables Of InterestAn analysis was made of the time profile and the number and duration of CSD and CSD-like episodes recorded from the ECoGs.ResultsOf the 16 patients enrolled, 9 presented episodes of CSD or CSD-like phenomena, of highly variable frequency and duration.ConclusionsEpisodes of CSD and CSD-like phenomena are frequently detected in the ischemic penumbra and/or traumatic cortical regions of patients with MMCAI who require decompressive craniectomy or of patients with contusional TBI.Copyright © 2013 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

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