Spreading Depressions as Secondary Insults after Traumatic Injury to the Human Brain.

摘要

This report describes year 4 progress of a multi-center study of neurosurgical TBI patients to determine the effects of spreading depression (SD), measured by electrocorticography, on neurologic outcome. In this year, we have enrolled 42 patients, bringing the study total to 136. Data collection, scoring, and monitoring has been completed for 90 patients. Using data from the present study combined with the pilot study, we published the finding that SD is independently associated with worse outcomes in 103 patients. These results establish SD as a mechanism of secondary injury. These analyses will be repeated with the full cohort from the present study and an advanced prognostic model will be developed based on more refined metrics of SD burden, secondary insults, and TBI pathoanatomy. Overall progress indicates that SD should be targeted therapeutically in a future interventional trial. We also found evidence that SD can be monitored non-invasively by scalp EEG recordings, thus providing a method to extend results to non-surgical TBI patients.