Is Spreading Depolarization a Risk Factor for Late Epilepsy? A Prospective Study in Patients with Traumatic Brain Injury and Malignant Ischemic Stroke Undergoing Decompressive Craniectomy

Autor: Manuel Quintana, M.A. Poca, María Sueiras, Vanessa Thonon, Estevo Santamarina, M. Riveiro, Angela Sánchez-Guerrero, Darío Gándara, Juan Sahuquillo
Rok vydání: 2020
Předmět:
Zdroj: Neurocritical Care. 34:876-888
ISSN: 1556-0961
1541-6933
DOI: 10.1007/s12028-020-01107-x
Popis: Spreading depolarizations (SDs) have been described in patients with ischemic and haemorrhagic stroke, traumatic brain injury, and migraine with aura, among other conditions. The exact pathophysiological mechanism of SDs is not yet fully established. Our aim in this study was to evaluate the relationship between the electrocorticography (ECoG) findings of SDs and/or epileptiform activity and subsequent epilepsy and electroclinical outcome. This was a prospective observational study of 39 adults, 17 with malignant middle cerebral artery infarction (MMCAI) and 22 with traumatic brain injury, who underwent decompressive craniectomy and multimodal neuromonitoring including ECoG in penumbral tissue. Serial electroencephalography (EEG) recordings were obtained for all surviving patients. Functional disability at 6 and 12 months after injury were assessed using the Barthel, modified Rankin (mRS), and Extended Glasgow Outcome (GOS-E) scales. SDs were recorded in 58.9% of patients, being more common—particularly those of isoelectric type—in patients with MMCAI (p
Databáze: OpenAIRE
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