OBJECTIVE: To test the co-occurrence and interrelation of ictal activity and cortical spreading depressions (CSDs) - including the related periinfarct depolarisations in acute brain injury caused by trauma, and spontaneous subarachnoid and/or intracerebral haemorrhage. METHODS: 63 patients underwent craniotomy and electrocorticographic (ECoG) recordings were taken near foci of damaged cortical tissue for up to 10 days. RESULTS: 32 of 63 patients exhibited CSDs (5-75 episodes) and 11 had ECoGraphic seizure activity (1-81 episodes). Occurrence of seizures was significantly associated with CSD, as 10 of 11 patients with seizures also had CSD (p=0.007, 2-tailed Fishers exact test). Clinically overt seizures were only observed in one patient. Each patient with CSD and seizures displayed one of four different patterns of interaction between CSD and seizures. In four patients CSD was immediately preceded by prolonged seizure activity. In three patients the two phenomena were separated in time: multiple CSDs were replaced by ictal activity. In one patient seizures appeared to trigger repeated CSDs at the adjacent electrode. In 2 patients ongoing repeated seizures were interrupted each time CSD occurred. CONCLUSIONS: Seizure activity occurs in association with CSD in the injured human brain. SIGNIFICANCE: ECoG recordings in brain injury patients provide insight into pathophysiological mechanisms, which are not accessible by scalp EEG recordings.
OBJECTIVE: To test the co-occurrence and interrelation of ictal activity and cortical spreading depressions (CSDs) - including the related periinfarct depolarisations in acute brain injury caused by trauma, and spontaneous subarachnoid and/or intracerebral haemorrhage. METHODS: 63 patients underwent craniotomy and electrocorticographic (ECoG) recordings were taken near foci of damaged cortical tissue for up to 10 days. RESULTS: 32 of 63 patients exhibited CSDs (5-75 episodes) and 11 had ECoGraphic seizure activity (1-81 episodes). Occurrence of seizures was significantly associated with CSD, as 10 of 11 patients with seizures also had CSD (p=0.007, 2-tailed Fishers exact test). Clinically overt seizures were only observed in one patient. Each patient with CSD and seizures displayed one of four different patterns of interaction between CSD and seizures. In four patients CSD was immediately preceded by prolonged seizure activity. In three patients the two phenomena were separated in time: multiple CSDs were replaced by ictal activity. In one patientseizures appeared to trigger repeated CSDs at the adjacent electrode. In 2 patients ongoing repeated seizures were interrupted each time CSD occurred. CONCLUSIONS:Seizure activity occurs in association with CSD in the injured human brain. SIGNIFICANCE: ECoG recordings in brain injurypatients provide insight into pathophysiological mechanisms, which are not accessible by scalp EEG recordings.
Authors: Jens P Dreier; Johannes Woitzik; Martin Fabricius; Robin Bhatia; Sebastian Major; Chistoph Drenckhahn; Thomas-Nicolas Lehmann; Asita Sarrafzadeh; Lisette Willumsen; Jed A Hartings; Oliver W Sakowitz; Jörg H Seemann; Anja Thieme; Martin Lauritzen; Anthony J Strong Journal: Brain Date: 2006-10-25 Impact factor: 13.501
Authors: P M Vespa; K O'Phelan; M Shah; J Mirabelli; S Starkman; C Kidwell; J Saver; M R Nuwer; J G Frazee; D A McArthur; N A Martin Journal: Neurology Date: 2003-05-13 Impact factor: 9.910
Authors: Martin Lauritzen; Jens Peter Dreier; Martin Fabricius; Jed A Hartings; Rudolf Graf; Anthony John Strong Journal: J Cereb Blood Flow Metab Date: 2010-11-03 Impact factor: 6.200
Authors: Joshua C Chang; Lydia L Shook; Jonathan Biag; Elaine N Nguyen; Arthur W Toga; Andrew C Charles; Kevin C Brennan Journal: Brain Date: 2010-03-25 Impact factor: 13.501
Authors: David Y Chung; Homa Sadeghian; Tao Qin; Sevda Lule; Hang Lee; Fahri Karakaya; Stacy Goins; Fumiaki Oka; Mohammad A Yaseen; Thijs Houben; Else A Tolner; Arn M J M van den Maagdenberg; Michael J Whalen; Sava Sakadžic; Cenk Ayata Journal: Cereb Cortex Date: 2019-03-01 Impact factor: 5.357