© 2013 Elsevier España, S.L.U. and SEMICYUC. Objectives: To determine the frequency and duration of cortical spreading depolarization (CSD) and CSD-like episodes in patients with traumatic brain injury (TBI) and malignant middle cerebral artery infarction (MMCAI) requiring craniotomy. Design: A descriptive observational study was carried out during 19 months. Setting: Neurocritical patients. Patients: Sixteen patients were included: 9 with MMCAI and 7 with moderate or severe TBI, requiring surgical treatment. Interventions: A 6-electrode subdural electrocorticographic (ECoG) strip was placed onto the perilesional cortex. Main variables of interest: An analysis was made of the time profile and the number and duration of CSD and CSD-like episodes recorded from the ECoGs. Results: Of the 16 patients enrolled, 9 presented episodes of CSD or CSD-like phenomena, of highly variable frequency and duration. Conclusions: Episodes of CSD and CSD-like phenomena are frequently detected in the ischemic penumbra and/or traumatic cortical regions of patients with MMCAI who require decompressive craniectomy or of patients with contusional TBI.
- Brain metabolism
- Brain tissue oxygen pressure
- Cortical spreading depolarization
- Malignant middle cerebral artery infarction
- Traumatic brain injury