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The continuum of spreading depolarizations in acute cortical lesion development: Examining Leão's legacy.
Hartings, Jed A; Shuttleworth, C William; Kirov, Sergei A; Ayata, Cenk; Hinzman, Jason M; Foreman, Brandon; Andrew, R David; Boutelle, Martyn G; Brennan, K C; Carlson, Andrew P; Dahlem, Markus A; Drenckhahn, Christoph; Dohmen, Christian; Fabricius, Martin; Farkas, Eszter; Feuerstein, Delphine; Graf, Rudolf; Helbok, Raimund; Lauritzen, Martin; Major, Sebastian; Oliveira-Ferreira, Ana I; Richter, Frank; Rosenthal, Eric S; Sakowitz, Oliver W; Sánchez-Porras, Renán; Santos, Edgar; Schöll, Michael; Strong, Anthony J; Urbach, Anja; Westover, M Brandon; Winkler, Maren Kl; Witte, Otto W; Woitzik, Johannes; Dreier, Jens P.
Afiliación
  • Hartings JA; 1 Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
  • Shuttleworth CW; 2 Mayfield Clinic, Cincinnati, OH, USA.
  • Kirov SA; 3 Department of Neuroscience, University of New Mexico School of Medicine, Albuquerque, NM, USA.
  • Ayata C; 4 Department of Neurosurgery and Brain and Behavior Discovery Institute, Medical College of Georgia, Augusta, GA, USA.
  • Hinzman JM; 5 Neurovascular Research Unit, Department of Radiology, and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Foreman B; 1 Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
  • Andrew RD; 6 Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
  • Boutelle MG; 7 Department of Biomedical & Molecular Sciences, Queen's University, Kingston, Ontario, Canada.
  • Brennan KC; 8 Department of Bioengineering, Imperial College London, London, United Kingdom.
  • Carlson AP; 9 Department of Neurology, University of Utah, Salt Lake City, UT, USA.
  • Dahlem MA; 10 Department of Neurobiology and Anatomy, University of Utah, Salt Lake City, UT, USA.
  • Drenckhahn C; 11 Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, NM, USA.
  • Dohmen C; 12 Department of Physics, Humboldt University of Berlin, Berlin, Germany.
  • Fabricius M; 13 Department of Neurology, Charité University Medicine, Berlin, Germany.
  • Farkas E; 14 Department of Neurology, University of Cologne, Cologne, Germany.
  • Feuerstein D; 15 Department of Clinical Neurophysiology, Rigshospitalet, Glostrup, Denmark.
  • Graf R; 16 Department of Medical Physics and Informatics, Faculty of Medicine, and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary.
  • Helbok R; 17 Multimodal Imaging of Brain Metabolism, Max-Planck-Institute for Metabolism Research, Cologne, Germany.
  • Lauritzen M; 17 Multimodal Imaging of Brain Metabolism, Max-Planck-Institute for Metabolism Research, Cologne, Germany.
  • Major S; 18 Medical University of Innsbruck, Department of Neurology, Neurocritical Care Unit, Innsbruck, Austria.
  • Oliveira-Ferreira AI; 15 Department of Clinical Neurophysiology, Rigshospitalet, Glostrup, Denmark.
  • Richter F; 19 Department of Neuroscience and Pharmacology and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.
  • Rosenthal ES; 13 Department of Neurology, Charité University Medicine, Berlin, Germany.
  • Sakowitz OW; 20 Center for Stroke Research Berlin, Charité University Medicine, Berlin, Germany.
  • Sánchez-Porras R; 21 Department of Experimental Neurology, Charité University Medicine, Berlin, Germany.
  • Santos E; 20 Center for Stroke Research Berlin, Charité University Medicine, Berlin, Germany.
  • Schöll M; 21 Department of Experimental Neurology, Charité University Medicine, Berlin, Germany.
  • Strong AJ; 22 Institute of Physiology/Neurophysiology, Jena University Hospital, Jena, Germany.
  • Urbach A; 5 Neurovascular Research Unit, Department of Radiology, and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Westover MB; 23 Department of Neurosurgery, Klinikum Ludwigsburg, Ludwigsburg, Germany.
  • Winkler MK; 24 Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
  • Witte OW; 24 Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
  • Woitzik J; 24 Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
  • Dreier JP; 24 Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
J Cereb Blood Flow Metab ; 37(5): 1571-1594, 2017 May.
Article en En | MEDLINE | ID: mdl-27328690
A modern understanding of how cerebral cortical lesions develop after acute brain injury is based on Aristides Leão's historic discoveries of spreading depression and asphyxial/anoxic depolarization. Treated as separate entities for decades, we now appreciate that these events define a continuum of spreading mass depolarizations, a concept that is central to understanding their pathologic effects. Within minutes of acute severe ischemia, the onset of persistent depolarization triggers the breakdown of ion homeostasis and development of cytotoxic edema. These persistent changes are diagnosed as diffusion restriction in magnetic resonance imaging and define the ischemic core. In delayed lesion growth, transient spreading depolarizations arise spontaneously in the ischemic penumbra and induce further persistent depolarization and excitotoxic damage, progressively expanding the ischemic core. The causal role of these waves in lesion development has been proven by real-time monitoring of electrophysiology, blood flow, and cytotoxic edema. The spreading depolarization continuum further applies to other models of acute cortical lesions, suggesting that it is a universal principle of cortical lesion development. These pathophysiologic concepts establish a working hypothesis for translation to human disease, where complex patterns of depolarizations are observed in acute brain injury and appear to mediate and signal ongoing secondary damage.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Depresión de Propagación Cortical / Lesiones Encefálicas / Corteza Cerebral / Circulación Cerebrovascular Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: J Cereb Blood Flow Metab Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Depresión de Propagación Cortical / Lesiones Encefálicas / Corteza Cerebral / Circulación Cerebrovascular Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: J Cereb Blood Flow Metab Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos