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The Hemodynamic Response of Spreading Depolarization Observed by Near Infrared Spectroscopy After Aneurysmal Subarachnoid Hemorrhage

Seule, Martin ; Keller, Emanuela ; Unterberg, Andreas ; Sakowitz, Oliver

In: Neurocritical Care, 2015, vol. 23, no. 1, p. 108-112

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    Titre
    • The Hemodynamic Response of Spreading Depolarization Observed by Near Infrared Spectroscopy After Aneurysmal Subarachnoid Hemorrhage
    Auteur
    • Seule, Martin. Department of Neurosurgery, University Heidelberg, Heidelberg, Germany
    • Keller, Emanuela. Neurointensive Care Unit, University Hospital Zurich, Zurich, Switzerland
    • Unterberg, Andreas. Department of Neurosurgery, University Heidelberg, Heidelberg, Germany
    • Sakowitz, Oliver. Department of Neurosurgery, University Heidelberg, Heidelberg, Germany
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Neurocritical Care, 2015, vol. 23, no. 1, p. 108-112. Springer US; http://www.springer-ny.com
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:332313
    Summary
    Background: Electrocorticography (ECoG) in brain-injured patients allows to detect spreading depolarization, a potential mechanism of secondary ischemia. Here, we describe the relationship of spreading depolarization with changes in cerebral hemodynamics using a brain tissue probe applying near infrared spectroscopy (NIRS). Methods: Simultaneous ECoG and NIRS monitoring was performed in a patient with severe aneurysmal subarachnoid hemorrhage. Changes in cerebral blood oxygenation and regional cerebral blood volume were studied before and after the occurrence of spreading depolarization. Cerebral blood flow measurements were performed daily using an indocyanine green dye dilution mode. Results: Single events of spreading depolarizations demonstrated with transient hyperoxic responses and increase in cerebral blood volume. On the other hand, temporal clusters of recurrent spreading depolarizations were associated with prolonged hypoxic responses and decrease in cerebral blood volume. Cerebral blood flow measurements showed higher values before compared to after onset of spreading depolarization (33.7±8.4 vs. 24.2±4.5ml/100g/min). Conclusions: The findings suggest that NIRS monitoring in the cerebral white matter might reflect the hemodynamic signature of spreading depolarization detected by ECoG recordings. This is of potential interest for the further development of both neuromonitoring methods.