Spreading Depressions as Secondary Insults After Traumatic Injury to the Human Brain
Annual rept. 1 Sep 2009-31 Aug 2010
CINCINNATI UNIV OH
Pagination or Media Count:
This report describes year 2 progress of a multi-center study of neurosurgical TBI patients to determine the effects of spreading depression SD on neurologic outcome. In this year, we have initiated our final study site and have enrolled 41 patients, bringing the study total to 61. Electrocorticographic ECoG recordings were made in patients for an average duration of 70 hours during intensive care, and 6 month clinical outcomes were assessed. Using admission risk factors as covariates, we have found a highly significant independent association of SD with poor outcome. Combining ECoG with microdialysis, we also found that SD is associated with excitotoxicity elevated glutamate and metabolic crisis elevated lactatepyruvate. Finally, analysis of direct current ECoG potentials showed that a significant subset of SD have prolonged durations, which is direct evidence of a harmful effect. These results suggests the study goals will be achieved and that SD should be targeted therapeutically in a future interventional trial.
- Medicine and Medical Research