What Should a Clinician Do When Spreading Depolarizations are Observed in a Patient?

Raimund Helbok; Jed A Hartings; Alois Schiefecker; Baptiste Balança; Sharon Jewel; Brandon Foreman; Ari Ercole; Ramani Balu; Cenk Ayata; Laura Ngwenya; Eric Rosenthal; Martyn G Boutelle; Eszter Farkas; Jens P Dreier; Martin Fabricius; C William Shuttleworth; Andrew Carlson

doi:10.1007/s12028-019-00777-6

What Should a Clinician Do When Spreading Depolarizations are Observed in a Patient?

Neurocrit Care. 2020 Feb;32(1):306-310. doi: 10.1007/s12028-019-00777-6.

Authors

Raimund Helbok¹, Jed A Hartings^{2

3

4}, Alois Schiefecker⁵, Baptiste Balança^{6

7

8

9}, Sharon Jewel^{10

11}, Brandon Foreman^{2

3

4

12}, Ari Ercole¹³, Ramani Balu¹⁴, Cenk Ayata¹⁵, Laura Ngwenya^{2

3

4

12}, Eric Rosenthal¹⁶, Martyn G Boutelle¹¹, Eszter Farkas¹⁷, Jens P Dreier^{6

18

19

20

21}, Martin Fabricius²², C William Shuttleworth²³, Andrew Carlson²⁴

Affiliations

¹ Department of Neurology, Neurocritical Care, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. raimund.helbok@tirol-kliniken.at.
² Department of Neurosurgery, University of Cincinnati (UC) College of Medicine, Cincinnati, OH, USA.
³ Collaborative for Research on Acute Neurologic Injury, University of Cincinnati (UC) College of Medicine, Cincinnati, OH, USA.
⁴ UC Gardner Neuroscience Institute, Cincinnati, OH, USA.
⁵ Department of Neurology, Neurocritical Care, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
⁶ Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁷ Department of Anesthesiology and Intensive Care Medicine, Hospices Civils de Lyon, Hôpital Pierre Wertheimer, Lyon, France.
⁸ Lyon Neuroscience Research Centre, Lyon, France.
⁹ Centre Lyonnais d'Enseignement par la Simulation en Santé, SAMSEI, Université Claude Bernard Lyon 1, Lyon, France.
¹⁰ Department of Basic and Clinical Neuroscience, King's College, London, UK.
¹¹ Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK.
¹² Department of Neurology and Rehabilitation Medicine, University of Cincinnati (UC) College of Medicine, Cincinnati, OH, USA.
¹³ Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK.
¹⁴ Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
¹⁵ Neurovascular Research Laboratory, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, USA.
¹⁶ Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA.
¹⁷ Department of Medical Informatics, University of Szeged, Szeged, H-6720, Hungary.
¹⁸ Department of Neurology, Charité - Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
¹⁹ Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
²⁰ Bernstein Center for Computational Neuroscience Berlin, Berlin, Germany.
²¹ Einstein Center for Neurosciences Berlin, Berlin, Germany.
²² Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark.
²³ Department of Neurosciences, University of New Mexico School of Medicine, Albuquerque, NM, 87131, USA.
²⁴ Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, NM, 87131, USA.

Abstract

The International Conference on Spreading Depolarizations (iCSD) held in Boca Raton, Florida, in the September of 2018 devoted a section to address the question, "What should a clinician do when spreading depolarizations are observed in a patient?" Discussants represented a wide range of expertise, including neurologists, neurointensivists, neuroradiologists, neurosurgeons, and pre-clinical neuroscientists, to provide both clinical and basic pathophysiology perspectives. A draft summary of viewpoints offered was then written by a multidisciplinary writing group of iCSD members, based on a transcript of the session. Feedback of all discussants was formally collated, reviewed, and incorporated into the final document which was subsequently approved by all authors.

Keywords: Cortical spreading depression; Electroencephalography; Intracerebral hemorrhage; Ischemic Stroke; Outcome; Subarachnoid hemorrhage; Traumatic brain injury.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Brain Injuries, Traumatic / drug therapy
Brain Injuries, Traumatic / physiopathology*
Cortical Spreading Depression*
Electrocorticography
Electroencephalography
Excitatory Amino Acid Antagonists / therapeutic use
Humans
Ketamine / therapeutic use
Outcome Assessment, Health Care
Precision Medicine
Stroke / drug therapy
Stroke / physiopathology*
Subarachnoid Hemorrhage / drug therapy
Subarachnoid Hemorrhage / physiopathology*

Substances

Excitatory Amino Acid Antagonists
Ketamine

Abstract

Publication types

MeSH terms

Substances

Grants and funding