Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Early focal brain injury after subarachnoid hemorrhage correlates with spreading depolarizations

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Randomized trial of daily high-dose vitamin D3 in patients with RRMS receiving subcutaneous interferon β-1a

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Author response: Nationwide prevalence and incidence study of neuromyelitis optica spectrum disorder in Denmark

    Research output: Contribution to journalComment/debateResearchpeer-review

  3. Fat oxidation is impaired during exercise in lipin-1 deficiency

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Declining malformation rates with changed antiepileptic drug prescribing: An observational study

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Neuromuscular adverse events associated with anti-PD-1 monoclonal antibodies: Systematic review

    Research output: Contribution to journalReviewResearchpeer-review

  1. Precapillary sphincters maintain perfusion in the cerebral cortex

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Diagnostic added value of electrical source imaging in presurgical evaluation of patients with epilepsy: A prospective study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Variation in the practice of tracheal intubation in Europe after traumatic brain injury: a prospective cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Nina Eriksen
  • Egill Rostrup
  • Martin Fabricius
  • Michael Scheel
  • Sebastian Major
  • Maren K L Winkler
  • Georg Bohner
  • Edgar Santos
  • Oliver W Sakowitz
  • Vasilis Kola
  • Clemens Reiffurth
  • Jed A Hartings
  • Peter Vajkoczy
  • Johannes Woitzik
  • Peter Martus
  • Martin Lauritzen
  • Bente Pakkenberg
  • Jens P Dreier
View graph of relations

OBJECTIVE: To investigate whether spreading depolarization (SD)-related variables at 2 different time windows (days 1-4 and 5-8) after aneurysmal subarachnoid hemorrhage (aSAH) correlate with the stereologically determined volume of early focal brain injury on the preinterventional CT scan.

METHODS: In this observational multicenter study of 54 patients, volumes of unaffected brain tissue, ventricles, cerebellum, aSAH, intracerebral hemorrhage, and focal parenchymal hypodensity were stereologically estimated. Patients were electrocorticographically monitored using subdural electrodes for 81.8 hours (median) (interquartile range: 70.6-90.5) during days 1-4 (n = 54) and for 75.9 (59.5-88.7) hours during days 5-8 (n = 51). Peak total SD-induced depression duration of a recording day (PTDDD) and peak numbers of (1) SDs, (2) isoelectric SDs, and (3) spreading depressions of a recording day were determined following the recommendations of the Co-Operative Studies on Brain Injury Depolarizations.

RESULTS: Thirty-three of 37 patients with early focal brain injury (intracerebral hemorrhage and/or hypodensity) in contrast to 7 of 17 without displayed SDs during days 1-4 (sensitivity: 89% [95% confidence interval, CI: 75%-97%], specificity: 59% [CI: 33%-82%], positive predictive value: 83% [CI: 67%-93%], negative predictive value: 71% [CI: 42%-92%], Fisher exact test, p < 0.001). All 4 SD-related variables during days 1-4 significantly correlated with the volume of early focal brain injury (Spearman rank order correlations). A multiple ordinal regression analysis identified the PTDDD as the most important predictor.

CONCLUSIONS: Our findings suggest that early focal brain injury after aSAH is associated with early SDs and further support the notion that SDs are a biomarker of focal brain lesions.

Original languageEnglish
JournalNeurology
Volume92
Issue number4
Pages (from-to)e326-e341
ISSN0028-3878
DOIs
Publication statusPublished - 2019

ID: 56204098