Effect of Locally Delivered Nimodipine Microparticles on Spreading Depolarization in Aneurysmal Subarachnoid Hemorrhage

2020 ◽  
Author(s):  
Andrew P. Carlson ◽  
Amal Alchbli ◽  
Daniel Hänggi ◽  
R. Loch Macdonald ◽  
C. William Shuttleworth
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Spreading Depolarization

scholarly journals Cortical Spreading Ischemia in the Absence of Proximal Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Evidence for a Dual Mechanism of Delayed Cerebral Ischemia

2011 ◽  
Vol 32 (2) ◽  
pp. 201-202 ◽  
Author(s):  
Anthony J Strong ◽  
R Loch Macdonald
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Preliminary Evidence ◽  
Circle Of Willis ◽  
Cerebral Microcirculation ◽  
Spreading Depolarization ◽  
Abnormal Response ◽  
Dual Mechanism

There are longstanding inconsistencies in the evidence thought to link vasospasm in the major branches of the Circle of Willis with delayed cerebral ischemia and poor outcome from aneurysmal subarachnoid hemorrhage (aSAH). The demonstrations, first in the laboratory, and more recently in patients with aSAH, of cortical spreading ischemia based on an abnormal response of the cerebral microcirculation to spreading depolarization offer an additional possible mechanism for delayed ischemia. That such events can occur in the substantial absence of proximal vasospasm is compatible with this concept, but the preliminary evidence needs support from more extensive studies.

scholarly journals Terminal spreading depolarizations causing electrocortical silencing prior to clinical brain death: case report

2019 ◽  
Vol 131 (6) ◽  
pp. 1773-1779 ◽  
Author(s):  
Andrew P. Carlson ◽  
C. William Shuttleworth ◽  
Sebastian Major ◽  
Coline L. Lemale ◽  
Jens P. Dreier ◽  
...  
Keyword(s):  
Case Report ◽  
Subarachnoid Hemorrhage ◽  
Brain Death ◽  
Human Brain ◽  
Brain Edema ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
First Report ◽  
Spreading Depolarization ◽  
Death Case ◽  
Cardiopulmonary Failure

The 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.

Cerebral Glucose and Spreading Depolarization in Patients with Aneurysmal Subarachnoid Hemorrhage

2012 ◽  
pp. 143-147 ◽  
Author(s):  
Asita Sarrafzadeh ◽  
Edgar Santos ◽  
Dirk Wiesenthal ◽  
Peter Martus ◽  
Peter Vajkoczy ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Spreading Depolarization

Cilostazol decreases duration of spreading depolarization and spreading ischemia after aneurysmal subarachnoid hemorrhage

2018 ◽  
Vol 84 (6) ◽  
pp. 873-885 ◽  
Author(s):  
Kazutaka Sugimoto ◽  
Sadahiro Nomura ◽  
Satoshi Shirao ◽  
Takao Inoue ◽  
Hideyuki Ishihara ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Spreading Depolarization

scholarly journals Oxygen availability and spreading depolarizations provide complementary prognostic information in neuromonitoring of aneurysmal subarachnoid hemorrhage patients

2016 ◽  
Vol 37 (5) ◽  
pp. 1841-1856 ◽  
Author(s):  
Maren KL Winkler ◽  
Nora Dengler ◽  
Nils Hecht ◽  
Jed A Hartings ◽  
Eun J Kang ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Partial Pressure ◽  
Spreading Depression ◽  
Neurocritical Care ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Predictors Of Outcome ◽  
Partial Pressure Of Oxygen ◽  
Prognostic Information ◽  
Spreading Depolarization

Multimodal neuromonitoring in neurocritical care increasingly includes electrocorticography to measure epileptic events and spreading depolarizations. Spreading depolarization causes spreading depression of activity (=isoelectricity) in electrically active tissue. If the depression is long-lasting, further spreading depolarizations occur in still isoelectric tissue where no activity can be suppressed. Such spreading depolarizations are termed isoelectric and are assumed to indicate energy compromise. However, experimental and clinical recordings suggest that long-lasting spreading depolarization-induced depression and isoelectric spreading depolarizations are often recorded outside of the actual ischemic zones, allowing the remote diagnosis of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. Here, we analyzed simultaneous electrocorticography and tissue partial pressure of oxygen recording in 33 aneurysmal subarachnoid hemorrhage patients. Multiple regression showed that both peak total depression duration per recording day and mean baseline tissue partial pressure of oxygen were independent predictors of outcome. Moreover, tissue partial pressure of oxygen preceding spreading depolarization was similar and differences in tissue partial pressure of oxygen responses to spreading depolarization were only subtle between isoelectric spreading depolarizations and spreading depressions. This further supports that, similar to clustering of spreading depolarizations, long spreading depolarization-induced periods of isoelectricity are useful to detect energy compromise remotely, which is valuable because the exact location of future developing pathology is unknown at the time when the neurosurgeon implants recording devices.

scholarly journals Simulation of spreading depolarization trajectories in cerebral cortex: Correlation of velocity and susceptibility in patients with aneurysmal subarachnoid hemorrhage

2017 ◽  
Vol 16 ◽  
pp. 524-538 ◽  
Author(s):  
Denny Milakara ◽  
Cristian Grozea ◽  
Markus Dahlem ◽  
Sebastian Major ◽  
Maren K.L. Winkler ◽  
...  
Keyword(s):  
Cerebral Cortex ◽  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Spreading Depolarization
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