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Recording, analysis, and interpretation of spreading depolarizations in neurointensive care: Review and recommendations of the COSBID research group
- Source :
- Journal of Cerebral Blood Flow and Metabolism, 37(5), 1595-1625, Journal of Cerebral Blood Flow and Metabolism, 37(5), 1595–1625. Nature Publishing Group, Journal of cerebral blood flow and metabolism
- Publication Year :
- 2016
- Publisher :
- SAGE Publications, 2016.
-
Abstract
- Spreading depolarizations (SD) are waves of abrupt, near-complete breakdown of neuronal transmembrane ion gradients, are the largest possible pathophysiologic disruption of viable cerebral gray matter, and are a crucial mechanism of lesion development. Spreading depolarizations are increasingly recorded during multimodal neuromonitoring in neurocritical care as a causal biomarker providing a diagnostic summary measure of metabolic failure and excitotoxic injury. Focal ischemia causes spreading depolarization within minutes. Further spreading depolarizations arise for hours to days due to energy supply-demand mismatch in viable tissue. Spreading depolarizations exacerbate neuronal injury through prolonged ionic breakdown and spreading depolarization-related hypoperfusion (spreading ischemia). Local duration of the depolarization indicates local tissue energy status and risk of injury. Regional electrocorticographic monitoring affords even remote detection of injury because spreading depolarizations propagate widely from ischemic or metabolically stressed zones; characteristic patterns, including temporal clusters of spreading depolarizations and persistent depression of spontaneous cortical activity, can be recognized and quantified. Here, we describe the experimental basis for interpreting these patterns and illustrate their translation to human disease. We further provide consensus recommendations for electrocorticographic methods to record, classify, and score spreading depolarizations and associated spreading depressions. These methods offer distinct advantages over other neuromonitoring modalities and allow for future refinement through less invasive and more automated approaches.
- Subjects :
- 0301 basic medicine
Spreading depolarization
cerebral blood flow
Review
Epileptogenesis
0302 clinical medicine
anoxic depolarization
asphyxial depolarization
Gray Matter
Electrocorticography
Review Articles
brain edema
spreading depression
medicine.diagnostic_test
spreading ischemia
Cortical Spreading Depression
Depolarization
Stroke
peri-infarct depolarization
neurocritical care
Neurology
Cerebral blood flow
Cortical spreading depression
Cerebrovascular Circulation
Practice Guidelines as Topic
brain trauma
neuroprotection
Cardiology and Cardiovascular Medicine
Critical Care
subarachnoid hemorrhage
neurovascular coupling
Ischemia
Focal ischemia
03 medical and health sciences
Journal Article
medicine
Humans
vasospasm
business.industry
Neurointensive care
medicine.disease
intracerebral hemorrhage
Neurophysiological Monitoring
global ischemia
030104 developmental biology
Brain Injuries
focal ischemia
epilepsy
epileptogenesis
Human medicine
Neurology (clinical)
business
Neuroscience
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 0271678X
- Database :
- OpenAIRE
- Journal :
- Journal of Cerebral Blood Flow and Metabolism, 37(5), 1595-1625, Journal of Cerebral Blood Flow and Metabolism, 37(5), 1595–1625. Nature Publishing Group, Journal of cerebral blood flow and metabolism
- Accession number :
- edsair.doi.dedup.....3ad6339be4383c1afbe3013d742caa94