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Cerebral Vasospasm: Neurovascular Events After Subarachnoid Hemorrhage pp 131–141Cite as

Full-Band Electrocorticography of Spreading Depolarizations in Patients with Aneurysmal Subarachnoid Hemorrhage

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Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 115))

Abstract

Cortical spreading depolarizations (CSDs) are a pathologic mechanism occurring in patients with aneurysmal subarachnoid hemorrhage and may contribute to delayed cerebral ischemia. We conducted a pilot study to determine the durations of depolarizations as measured by the negative direct current shifts in electrocorticography. Cortical electrode strips were placed in six patients (aged 35–63 years, Fisher grade 4, World Federation of Neurosurgical Societies [WFNS] 3–4) with ruptured aneurysms treated by clip ligation. Full-band electrocorticography was performed by direct current amplification (g.USBamp, Guger Tec, Graz, Austria) with ±250-mV range, 24-bit digitization, and recording/display with a customized BCI2000 platform. We recorded 191 CSDs in 4 patients, and direct current shifts of CSD (n = 403) were measured at 20 electrodes. Amplitudes were 7.2 mV (median; quartiles 6.2, 7.9), and durations were 2 min 14 s (1:53, 2:45). Ten direct current shifts in two patients with delayed infarcts were longer than 10 min, ranging up to 28 min. Taken together with previous studies, results suggest a threshold of 3–3.5 min to distinguish a normally distributed class of short CSDs with spreading hyperemia from prolonged CSDs with initial spreading ischemia. Results further demonstrate the clinical feasibility of direct current electrocorticography to monitor CSDs and assess their role in the pathology and management of subarachnoid hemorrhage.

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Acknowledgments

Supported by a grant from the Mayfield Educa­tion and Research Foundation. Dr. Dreier acknowledges support from the Deutsche Forschungsgemeinschaft (DFG DR 323/5-1) and the Bundesministerium für Bildung und Forschung (Center for Stroke Research Berlin, 01 EO 0801).

Conflicts of Interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, Neuroscience Institute, University of Cincinnati College of Medicine, 260 Stetson Street, Suite 2200, Cincinnati, OH, 45219, USA

    Jed A. Hartings Ph.D., J. Adam Wilson, Lori A. Shutter, Andrew Ringer & Mario Zuccarello

  2. University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Andrew C. Look

  3. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Achala Vagal

  4. Departments of Neurology and Experimental Neurology, Centre for Stroke Research, Charité University Medicine, Berlin, Germany

    Jens P. Dreier

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  1. Jed A. Hartings Ph.D.
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  2. J. Adam Wilson
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  3. Andrew C. Look
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  4. Achala Vagal
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  5. Lori A. Shutter
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  6. Jens P. Dreier
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  7. Andrew Ringer
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  8. Mario Zuccarello
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Corresponding author

Correspondence to Jed A. Hartings Ph.D. .

Editor information

Editors and Affiliations

  1. , Department of Neurosurgery, University of Cincinnati, Stetson, Suite 2200 260, Cincinnati, 45267-0515, Ohio, USA

    Mario Zuccarello

  2. College of Medicine, Department of Neurology, University of Cincinnati, Albert Sabin Way 231MSB room 1, Cincinnati, 46267-0536, Ohio, USA

    Joseph F. Clark

  3. College of Medicine, Dept. of Neurology and Neurosurgery, University of Cincinnati, Albert Sabin Way 231ML0517, Cincinnati, 45267-0517, Ohio, USA

    Gail Pyne-Geithman

  4. College of Medicine, Dept. of Neurosurgery, University of Cincinnati, Stetson St. Suite 260ML0515, Cincinnati, 45219, Ohio, USA

    Norberto Andaluz

  5. College of Medicine, Dept. of Neurosurgery, University of Cincinnati, Stetson, Suite 2200 260, Cincinnati, 45219, Ohio, USA

    Jed A. Hartings

  6. , Dept. of Emergency Medicine, University of Cincinnati, Albert Sabin Way 231ML0769, Cincinnati, 45267-0769, Ohio, USA

    Opeolu M. Adeoye

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© 2013 Springer-Verlag Wien

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Hartings, J.A. et al. (2013). Full-Band Electrocorticography of Spreading Depolarizations in Patients with Aneurysmal Subarachnoid Hemorrhage. In: Zuccarello, M., Clark, J., Pyne-Geithman, G., Andaluz, N., Hartings, J., Adeoye, O. (eds) Cerebral Vasospasm: Neurovascular Events After Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, vol 115. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1192-5_27

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  • DOI: https://doi.org/10.1007/978-3-7091-1192-5_27

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  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-1191-8

  • Online ISBN: 978-3-7091-1192-5

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