gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

Hemodynamic and metabolic changes associated with Cortical Spreading Depolarization in humans

Hämodynamische und metabolische Veränderungen aufgrund von Cortical Spreading Depolarization

Meeting Abstract

  • corresponding author J. Woitzik - Charité - Berlin, Klinik für Neurochirurgie, Berlin
  • N. Hecht - Charité - Berlin, Klinik für Neurochirurgie, Berlin
  • J. P. Dreier - Charité - Berlin, Klinik für Neurologie, Berlin
  • C. Manville - Universitätsklinikum Mannheim, Klinik für Neurochirurgie, Mannheim
  • M. Diepers - Universitätsklinikum Mannheim, Klinik für Neuroradiologie, Mannheim
  • O. Sakowitz - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg
  • B. Bosche - Univeritätsklinikum Köln, Klinik für Neurochirurgie, Köln
  • C. Dohmen - Univeritätsklinikum Köln, Klinik für Neurologie, Köln
  • R. Graf - Max-Planck-Institut für Neurologische Forschung, Köln

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 117

The electronic version of this article is the complete one and can be found online at:

Published: May 30, 2008

© 2008 Woitzik et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



For the COSBID study group

Objective: In healthy brain tissue Cortical Spreading Depolarization (CSD) is associated with increases in brain perfusion and oxygenation. In injured brain tissue, however, hypoperfusion and hypooxygenation were demonstrated in conjunction with CSD which can significantly contribute to lesion evolution under experimental settings. With the observation that CSD occurs frequently in patients with brain trauma and subarachnoid haemorrhage we have measured tissue perfusion and oxygenation together with electrocorticography (ECoG) in patients with different brain pathologies.

Methods: 10 patients who required surgery for traumatic brain injury or subarachnoid haemorrhage were recruited by members of the Co-operative Study on Brain Injury Depolarizations (COSBID) study group. A 6-contact ECoG recording strip (Wyler), brain tissue oxygen probe (Licox) and thermal diffusion microprobe (Hemedex) was placed cortically through the craniotomy. Thereafter, the patients were monitored for up to 10 days.

Results: CSD was repeatedly associated with an increase in perfusion (max. increase from 27.7 ml/100g/min to 43.3 ml/100g/min; 56.7 %) and oxygenation (max. increase from 30.6 mmHg to 41.3 mmHg; 35.1%) in mildly damaged brain tissue, whereas in patients with poor neurological condition CSD was associated with decreases in perfusion (max. decrease from 51.7 ml/100g/min to 42.1 ml/100g/min; 18.8 %) and oxygenation (max. decrease from 21.6 mmHg to 13.7 mmHg; 36.3%).

Conclusions: CSD occurring in human brain injury can be associated with varying hemodynamic and metabolic changes. According to our results, the severity of tissue damage seems to determine whether there is an increase or decrease in perfusion and oxygenation.