Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Scalp-recorded cortical spreading depolarizations (CSDs) of EEG with time constant of 2 seconds in a patient with acute traumatic brain injury

Takahito Tsukamoto, M.D.1)2), Shunsuke Kajikawa, M.D.1), Takefumi Hitomi, M.D., Ph.D.3)4), Takeshi Funaki, M.D., Ph.D.5), Makoto Urushitani, M.D., Ph.D.2), Ryosuke Takahashi, M.D., Ph.D.1) and Akio Ikeda, M.D., Ph.D.4)

1) Department of Neurology, Kyoto University Graduate School of Medicine
2) Department of Neurology, Shiga University of Medical Science
3) Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine
4) Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine
5) Department of Neurosurgery, Kyoto University Graduate School of Medicine

An 82-year-old female suffered from head trauma, and developed acute consciousness disturbance 6 days after the event. Head CT showed the acute subdural hematoma in the left temporooccipital area and the patient underwent emergency hematoma evacuation and decompression. However, her consciousness disturbance became worse after surgery. Intermittent large negative infraslow shifts (lasting longer than 40 seconds) were recorded in the right posterior quadrant by scalp EEG with TC of 2 sec, that was defined as cortical spreading depolarizations (CSDs). Clinically consciousness disturbance sustained poor until 1 month after surgery in spite of treatment by anti-epileptic drugs. CSDs were observed on the right side where head injury most likely occurred. It may explain the sustained consciousness disturbance associated with significant prolonged ischemia. Once scalp EEG could record CSDs in this particular patient, the degree and its prognosis of traumatic head injury were estimated.
Supplementary data
CSD analysis method in scalp EEG
Full Text of this Article in Japanese PDF (9298K)

(CLINICA NEUROL, 60: 473−478, 2020)
key words: cortical spreading depolarizations, electroencephalogram, time constant of 2 sec, acute traumatic brain injury

(Received: 2-Feb-20)