Cortical spreading depression recorded from the human brain using a multiparametric monitoring system

Avraham Mayevsky, Avi Doron, Tamar Manor, Sigal Meilin, Nili Zarchin, George E. Ouaknine

Research output: Contribution to journalArticlepeer-review

234 Scopus citations


The number of parameters (i.e., EEG or ICP-intracranial pressure) routinely monitored under clinical situations is limited. The brain function analyzer described in this paper enables simultaneous, continuous on-line monitoring of cerebral blood flow (CBF) and volume (CBV), intramitochondrial NADH redox state, extracellular K+ concentrations, DC potential, electrocorticography and ICP from the cerebral cortex. Brain function of 14 patients with severe head injury (GCS ≤ 8), who were hospitalized in the neurosurgical or general intensive care unit was monitored using this analyzer. Leao cortical spreading depression (SD) has been reported in many experimental animals but not in the human cerebral cortex. In one of the patients monitored, spreading depression was observed. This is the first time that spontaneous repetitive cortical SD cycles have been recorded from the cerebral cortex of a patient suffering from severe head injury. Typical SD cycles appeared 4-5 h after the beginning of monitoring this patient. During the first 3-4 cycles the responses of this patient were very similar to the responses to SD recorded in normoxic experimental animals. Electrocorticography was depressed whereas extracellular K+ levels increased. The metabolic response to spreading depression was characterized by oxidation of intramitochondrial NADH concomitant to a large increase in CBF. During brain death, an ischemic depolarization, characterized by decrease in CBF and an irreversible increase in extracellular K+, was recorded.

Original languageEnglish
Pages (from-to)268-274
Number of pages7
JournalBrain Research
Issue number1-2
StatePublished - 18 Nov 1996

Bibliographical note

Funding Information:
This paper is dedicated to Britton Chance for his continued inspiration in the development and application of new in vivo technologies for the clinical environment. We thank the Harry Stern Family Foundation (Phila, PA, USA) for generous support of this study.


  • NADH redox state
  • cerebral blood flow
  • cortical spreading depression
  • extracellular K
  • head trauma
  • human brain monitoring
  • intracranial pressure
  • multiparametric monitoring


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