• Andrew P Carlson, ShuttleworthC WilliamCW2Neurosciences, University of New Mexico, Albuquerque, New Mexico., Sebastian Major, Coline L Lemale, Jens P Dreier, and Jed A Hartings.
• Departments of1Neurosurgery and.
• J. Neurosurg. 2019 Dec 1; 131 (6): 177317791773-1779.

AbstractThe authors report on a 57-year-old woman in whom progression to brain death occurred on day 9 after aneurysmal subarachnoid hemorrhage without evidence of significant brain edema or vasospasm. Neuromonitoring demonstrated that brain death was preceded by a series of cortical spreading depolarizations that occurred in association with progressive hypoxic episodes. The depolarizations induced final electrical silence in the cortex and ended with a terminal depolarization that persisted > 7 hours. To the authors' knowledge, this is the first report of terminal spreading depolarization in the human brain prior to clinical brain death and major cardiopulmonary failure.

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