Is Spreading Depolarization a Risk Factor for Late Epilepsy? A Prospective Study in Patients with Traumatic Brain Injury
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ORIGINAL WORK
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 Maria Sueiras1,2,3* , Vanessa Thonon1, Estevo Santamarina4, Ángela Sánchez‑Guerrero2, Marilyn Riveiro5, Maria‑Antonia Poca2,3,6, Manuel Quintana4, Dario Gándara2,6 and Juan Sahuquillo2,3,6 © 2020 Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society
Abstract Objective: 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 electrocorticogra‑ phy (ECoG) findings of SDs and/or epileptiform activity and subsequent epilepsy and electroclinical outcome. Methods: This was a prospective observational study of 39 adults, 17 with malignant middle cerebral artery infarc‑ tion (MMCAI) and 22 with traumatic brain injury, who underwent decompressive craniectomy and multimodal neu‑ romonitoring 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. Results: SDs were recorded in 58.9% of patients, being more common—particularly those of isoelectric type—in patients with MMCAI (p
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