Observational Study of Cortical Spreading Depression in Human Brain Trauma

Since the primary damage from traumatic brain injury (TBI) is irreversible, the focus of
medical management of TBI is preventing secondary injury that can be life-threatening and
worsen patient outcome. Insight into the pathologic mechanisms of secondary injury, which are
largely unknown, is required for developing better treatments.

In preliminary studies, the investigators have found that a pathologic brain activity, known
as spreading depression, recurs in a large number of TBI patients in the first week after
injury. Spreading depressions are short-circuits of brain function that arise spontaneously
from an injury and spread repeatedly as waves into neighboring brain tissue. Animal research
has shown that spreading depressions can cause secondary injury to the brain.

The primary objective of this observational study is to determine whether the occurrence or
severity of spreading depression is related to worse neurologic recovery from TBI. Results
from the study will determine whether monitoring of spreading depression should be used as a
guide or target for improved medical management of the TBI patient.