SlideShare a Scribd company logo
1 of 16
Cortical spreading depolarizations are a novel mechanism independently associated with unfavorable clinical outcome in TBI Jed Hartings, PhD Department of Neurosurgery University of Cincinnati [email_address] 513-558-3567 COSBID
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object]
Spreading depolarizations Spreading depolarizations = class of pathologic waves characterized by near-complete sustained depolarization of neurons/astrocytes that propagate through gray matter at 1-5 mm/min ,[object Object],[object Object],[object Object],[object Object],[object Object]
Spreading depolarizations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Intracellular Extracellular (ECoG)
Electrocorticography (ECoG) Methods ,[object Object],[object Object],[object Object]
Electrocorticography (ECoG) Methods
Objective Study Aim To test the null hypothesis that  depolarizations have no  independent  association with 6-month outcomes after TBI , after controlling for established prognostic factors in multivariate analysis ,[object Object],[object Object]
Study Design ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*Marmarou et al. J Neurotrauma 2007 24(2):239-50. Hukkelhoven et al. J Neurotrauma 2005 22(10):1025-39.
Study Design Outcome measure extended Glasgow Outcome Scale (eGOS) at 6 months ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*Hukkelhoven et al. J Neurotrauma 2005 22(10):1025-39 Variables
Study Design ,[object Object],[object Object],[object Object],[object Object],*Fabricius et al., Brain, 129:778-90, 2006
Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ISD (n=20) CSD (n=38) None (n=45)
Results No differences in recording durations (p>0.50), timing of surgery (p>0.50), or prognostic scores (p=0.34). Significant difference in outcome between depolarization categories Ο‡ 2 ,  p<0.01 Poor outcome  (dead, VS, severe disability) ISD CSD None Poor outcome More likely Less likely Prognostic scores
Results *p=0.26 ^p<0.001 Multivariate ordinal regression analysis Estimated common odds ratio 95% confidence interval p-value Prognostic Score 1.76 1.26 to 2.46 <0.001 Depolarization None 1.0 reference <0.001 CSD 1.56* 0.72 to 3.37 ISD 7.58^ 2.64 to 21.8 Depolarization No 1.0 reference 0.01 Yes 2.55 1.25 to 5.20
Conclusions ,[object Object],[object Object],[object Object],[object Object]
Considerations ,[object Object],[object Object],[object Object],[object Object]
Acknowledgments Ross Bullock – Miami, FL David Okonkwo – Pittsburgh, PA Lilian Murray – Glasgow, Scotland Gordon Murray – Glasgow, Scotland Martin Fabricius – Copenhagen, Denmark Andrew Maas – Edegem, Belgium Johannes Woitzik – Berlin, Germany Oliver Sakowitz – Heidelberg, Germany Bruce Mathern – Richmond, VA Bob Roozenbeek – Rotterdam, Netherlands Hester Lingsma – Rotterdam, Netherlands Jens Dreier – Berlin, Germany Ava Puccio – Pittsburgh, PA Lori Shutter – Cincinnati, OH Clemens Pahl – London, UK Anthony Strong – London, UK COSBID U.S. Army CDMRP PH/TBI Research Program, Contract  No. W81XWH-08-2-0016

More Related Content

What's hot

Brain monitoring using intraparenchymal cathters
Brain monitoring using intraparenchymal cathtersBrain monitoring using intraparenchymal cathters
Brain monitoring using intraparenchymal cathterspgpapanikolaou
Β 
Using microdialysis for clinical decisions in head injury
Using microdialysis for clinical decisions in head injuryUsing microdialysis for clinical decisions in head injury
Using microdialysis for clinical decisions in head injurypgpapanikolaou
Β 
Neurosarcoidosis Indication For Radiotherapy
Neurosarcoidosis Indication For RadiotherapyNeurosarcoidosis Indication For Radiotherapy
Neurosarcoidosis Indication For Radiotherapyfondas vakalis
Β 
Molecular Vision Publication by Anuradha Singh
Molecular Vision Publication by Anuradha SinghMolecular Vision Publication by Anuradha Singh
Molecular Vision Publication by Anuradha SinghAnuradha Singh
Β 
Pharmacological neuroprotection in blinding eye diseases
 Pharmacological neuroprotection in blinding eye diseases Pharmacological neuroprotection in blinding eye diseases
Pharmacological neuroprotection in blinding eye diseasesAlexander Decker
Β 
Baclofen pump
Baclofen pumpBaclofen pump
Baclofen pumpAmit Ghosh
Β 
Neurocysticercosis the notorious vanishing ring enhancing lesion ijar feb 2015
Neurocysticercosis the notorious vanishing ring enhancing lesion   ijar feb 2015Neurocysticercosis the notorious vanishing ring enhancing lesion   ijar feb 2015
Neurocysticercosis the notorious vanishing ring enhancing lesion ijar feb 2015Sachin Adukia
Β 
Neuropathologic asses alzh dis
Neuropathologic asses alzh disNeuropathologic asses alzh dis
Neuropathologic asses alzh disayhan bΓΆlΓΌk
Β 
Neurologic complications
Neurologic complicationsNeurologic complications
Neurologic complicationsHans Garcia
Β 
Stem Cell Transplantation for Stroke
Stem Cell Transplantation for StrokeStem Cell Transplantation for Stroke
Stem Cell Transplantation for StrokeAnkita-rastogi
Β 
Journal club 17
Journal club 17Journal club 17
Journal club 17NeurologyKota
Β 
APPLY MACHINE LEARNING METHODS TO PREDICT FAILURE OF GLAUCOMA DRAINAGE
APPLY MACHINE LEARNING METHODS TO PREDICT FAILURE OF GLAUCOMA DRAINAGEAPPLY MACHINE LEARNING METHODS TO PREDICT FAILURE OF GLAUCOMA DRAINAGE
APPLY MACHINE LEARNING METHODS TO PREDICT FAILURE OF GLAUCOMA DRAINAGEIJDKP
Β 
The Lancet - Human embryonic stem cell-derived retinal pigment epithelium in...
The Lancet - Human embryonic stem cell-derived retinal pigment  epithelium in...The Lancet - Human embryonic stem cell-derived retinal pigment  epithelium in...
The Lancet - Human embryonic stem cell-derived retinal pigment epithelium in...John Redaelli
Β 
Anti thrombotic in patients with af undergoing pci
Anti thrombotic in patients with af undergoing pciAnti thrombotic in patients with af undergoing pci
Anti thrombotic in patients with af undergoing pciajay pratap singh
Β 
Vasküler Nâroşirürjide Gelecek
Vasküler Nâroşirürjide GelecekVasküler Nâroşirürjide Gelecek
Vasküler Nâroşirürjide Gelecekarifcan
Β 
Carrie Bearden: Studying Psychosis in 22q11 Deletion Syndrome
Carrie Bearden: Studying Psychosis in 22q11 Deletion SyndromeCarrie Bearden: Studying Psychosis in 22q11 Deletion Syndrome
Carrie Bearden: Studying Psychosis in 22q11 Deletion Syndromewef
Β 
Stich ii trial for supratentorial intra cerebral bleed
Stich ii trial for supratentorial intra cerebral bleedStich ii trial for supratentorial intra cerebral bleed
Stich ii trial for supratentorial intra cerebral bleedgarry07
Β 

What's hot (19)

Brain monitoring using intraparenchymal cathters
Brain monitoring using intraparenchymal cathtersBrain monitoring using intraparenchymal cathters
Brain monitoring using intraparenchymal cathters
Β 
Using microdialysis for clinical decisions in head injury
Using microdialysis for clinical decisions in head injuryUsing microdialysis for clinical decisions in head injury
Using microdialysis for clinical decisions in head injury
Β 
Neurosarcoidosis Indication For Radiotherapy
Neurosarcoidosis Indication For RadiotherapyNeurosarcoidosis Indication For Radiotherapy
Neurosarcoidosis Indication For Radiotherapy
Β 
Molecular Vision Publication by Anuradha Singh
Molecular Vision Publication by Anuradha SinghMolecular Vision Publication by Anuradha Singh
Molecular Vision Publication by Anuradha Singh
Β 
Pharmacological neuroprotection in blinding eye diseases
 Pharmacological neuroprotection in blinding eye diseases Pharmacological neuroprotection in blinding eye diseases
Pharmacological neuroprotection in blinding eye diseases
Β 
Baclofen pump
Baclofen pumpBaclofen pump
Baclofen pump
Β 
Articulo Gerardo 10_07_14
Articulo Gerardo 10_07_14Articulo Gerardo 10_07_14
Articulo Gerardo 10_07_14
Β 
Neurocysticercosis the notorious vanishing ring enhancing lesion ijar feb 2015
Neurocysticercosis the notorious vanishing ring enhancing lesion   ijar feb 2015Neurocysticercosis the notorious vanishing ring enhancing lesion   ijar feb 2015
Neurocysticercosis the notorious vanishing ring enhancing lesion ijar feb 2015
Β 
Neuropathologic asses alzh dis
Neuropathologic asses alzh disNeuropathologic asses alzh dis
Neuropathologic asses alzh dis
Β 
Neurologic complications
Neurologic complicationsNeurologic complications
Neurologic complications
Β 
Stem Cell Transplantation for Stroke
Stem Cell Transplantation for StrokeStem Cell Transplantation for Stroke
Stem Cell Transplantation for Stroke
Β 
Journal club 17
Journal club 17Journal club 17
Journal club 17
Β 
APPLY MACHINE LEARNING METHODS TO PREDICT FAILURE OF GLAUCOMA DRAINAGE
APPLY MACHINE LEARNING METHODS TO PREDICT FAILURE OF GLAUCOMA DRAINAGEAPPLY MACHINE LEARNING METHODS TO PREDICT FAILURE OF GLAUCOMA DRAINAGE
APPLY MACHINE LEARNING METHODS TO PREDICT FAILURE OF GLAUCOMA DRAINAGE
Β 
The Lancet - Human embryonic stem cell-derived retinal pigment epithelium in...
The Lancet - Human embryonic stem cell-derived retinal pigment  epithelium in...The Lancet - Human embryonic stem cell-derived retinal pigment  epithelium in...
The Lancet - Human embryonic stem cell-derived retinal pigment epithelium in...
Β 
Anti thrombotic in patients with af undergoing pci
Anti thrombotic in patients with af undergoing pciAnti thrombotic in patients with af undergoing pci
Anti thrombotic in patients with af undergoing pci
Β 
Summary_PhD
Summary_PhDSummary_PhD
Summary_PhD
Β 
Vasküler Nâroşirürjide Gelecek
Vasküler Nâroşirürjide GelecekVasküler Nâroşirürjide Gelecek
Vasküler Nâroşirürjide Gelecek
Β 
Carrie Bearden: Studying Psychosis in 22q11 Deletion Syndrome
Carrie Bearden: Studying Psychosis in 22q11 Deletion SyndromeCarrie Bearden: Studying Psychosis in 22q11 Deletion Syndrome
Carrie Bearden: Studying Psychosis in 22q11 Deletion Syndrome
Β 
Stich ii trial for supratentorial intra cerebral bleed
Stich ii trial for supratentorial intra cerebral bleedStich ii trial for supratentorial intra cerebral bleed
Stich ii trial for supratentorial intra cerebral bleed
Β 

Viewers also liked

TΖ° vαΊ₯n chọn mua lαΊ―p Δ‘αΊ·t camera quan sΓ‘t (giΓ‘m sΓ‘t) chα»‘ng trα»™m qua mαΊ‘ng
TΖ° vαΊ₯n chọn mua lαΊ―p Δ‘αΊ·t camera quan sΓ‘t (giΓ‘m sΓ‘t) chα»‘ng trα»™m qua mαΊ‘ngTΖ° vαΊ₯n chọn mua lαΊ―p Δ‘αΊ·t camera quan sΓ‘t (giΓ‘m sΓ‘t) chα»‘ng trα»™m qua mαΊ‘ng
TΖ° vαΊ₯n chọn mua lαΊ―p Δ‘αΊ·t camera quan sΓ‘t (giΓ‘m sΓ‘t) chα»‘ng trα»™m qua mαΊ‘ngLΓͺ Quα»‘c ToΓ n
Β 
Resume_Dip_Shah
Resume_Dip_ShahResume_Dip_Shah
Resume_Dip_ShahDip Shah
Β 
Sentencing theories 2011
Sentencing theories 2011Sentencing theories 2011
Sentencing theories 2011Miss Hart
Β 
introduccion a la literatura
introduccion a la literaturaintroduccion a la literatura
introduccion a la literaturaprincesita
Β 
Trend delle emissioni governative italiane 3 dicembre 2016
Trend delle emissioni governative italiane 3 dicembre 2016Trend delle emissioni governative italiane 3 dicembre 2016
Trend delle emissioni governative italiane 3 dicembre 2016salvatore barbato
Β 
Coursera DPY43JSUW828
Coursera DPY43JSUW828Coursera DPY43JSUW828
Coursera DPY43JSUW828Amit Kulkarni
Β 
Osservatorio start up innov. 20 giugno 2016
Osservatorio start up innov.  20 giugno  2016Osservatorio start up innov.  20 giugno  2016
Osservatorio start up innov. 20 giugno 2016salvatore barbato
Β 
Osservatorio start up innovative 4 gen 2016
Osservatorio start up innovative  4 gen 2016Osservatorio start up innovative  4 gen 2016
Osservatorio start up innovative 4 gen 2016salvatore barbato
Β 
[Học SEO Online] BΓ i 2: TαΊ‘o Website vα»›i blogger
[Học SEO Online] BΓ i 2: TαΊ‘o Website vα»›i blogger[Học SEO Online] BΓ i 2: TαΊ‘o Website vα»›i blogger
[Học SEO Online] BΓ i 2: TαΊ‘o Website vα»›i bloggerĐình Tỉnh
Β 
BMO Education & Conference Centre Presentation
BMO Education & Conference Centre PresentationBMO Education & Conference Centre Presentation
BMO Education & Conference Centre PresentationIgnite Magazine
Β 
Neuronal migration disorders
Neuronal migration disordersNeuronal migration disorders
Neuronal migration disordersAmr Hassan
Β 

Viewers also liked (17)

TΖ° vαΊ₯n chọn mua lαΊ―p Δ‘αΊ·t camera quan sΓ‘t (giΓ‘m sΓ‘t) chα»‘ng trα»™m qua mαΊ‘ng
TΖ° vαΊ₯n chọn mua lαΊ―p Δ‘αΊ·t camera quan sΓ‘t (giΓ‘m sΓ‘t) chα»‘ng trα»™m qua mαΊ‘ngTΖ° vαΊ₯n chọn mua lαΊ―p Δ‘αΊ·t camera quan sΓ‘t (giΓ‘m sΓ‘t) chα»‘ng trα»™m qua mαΊ‘ng
TΖ° vαΊ₯n chọn mua lαΊ―p Δ‘αΊ·t camera quan sΓ‘t (giΓ‘m sΓ‘t) chα»‘ng trα»™m qua mαΊ‘ng
Β 
Resume_Dip_Shah
Resume_Dip_ShahResume_Dip_Shah
Resume_Dip_Shah
Β 
Armonda, Rocco
Armonda, RoccoArmonda, Rocco
Armonda, Rocco
Β 
Sentencing theories 2011
Sentencing theories 2011Sentencing theories 2011
Sentencing theories 2011
Β 
introduccion a la literatura
introduccion a la literaturaintroduccion a la literatura
introduccion a la literatura
Β 
Trend delle emissioni governative italiane 3 dicembre 2016
Trend delle emissioni governative italiane 3 dicembre 2016Trend delle emissioni governative italiane 3 dicembre 2016
Trend delle emissioni governative italiane 3 dicembre 2016
Β 
TRIPS
TRIPSTRIPS
TRIPS
Β 
Coursera DPY43JSUW828
Coursera DPY43JSUW828Coursera DPY43JSUW828
Coursera DPY43JSUW828
Β 
Osservatorio start up innov. 20 giugno 2016
Osservatorio start up innov.  20 giugno  2016Osservatorio start up innov.  20 giugno  2016
Osservatorio start up innov. 20 giugno 2016
Β 
Osservatorio start up innovative 4 gen 2016
Osservatorio start up innovative  4 gen 2016Osservatorio start up innovative  4 gen 2016
Osservatorio start up innovative 4 gen 2016
Β 
Prestige sycamore
Prestige sycamore Prestige sycamore
Prestige sycamore
Β 
Zasler, Nathan
Zasler, NathanZasler, Nathan
Zasler, Nathan
Β 
[Học SEO Online] BΓ i 2: TαΊ‘o Website vα»›i blogger
[Học SEO Online] BΓ i 2: TαΊ‘o Website vα»›i blogger[Học SEO Online] BΓ i 2: TαΊ‘o Website vα»›i blogger
[Học SEO Online] BΓ i 2: TαΊ‘o Website vα»›i blogger
Β 
BMO Education & Conference Centre Presentation
BMO Education & Conference Centre PresentationBMO Education & Conference Centre Presentation
BMO Education & Conference Centre Presentation
Β 
Neuronal migration disorders
Neuronal migration disordersNeuronal migration disorders
Neuronal migration disorders
Β 
Lambda waves
Lambda wavesLambda waves
Lambda waves
Β 
Presentation on Sports Wear
Presentation on Sports WearPresentation on Sports Wear
Presentation on Sports Wear
Β 

Similar to Hartings, Jed - Outcome

Terrando et al-2015-anesthesia_&_analgesia
Terrando et al-2015-anesthesia_&_analgesiaTerrando et al-2015-anesthesia_&_analgesia
Terrando et al-2015-anesthesia_&_analgesiasamirsharshar
Β 
Dr Vikash_re irradiation_brain tumors.pdf
Dr Vikash_re irradiation_brain tumors.pdfDr Vikash_re irradiation_brain tumors.pdf
Dr Vikash_re irradiation_brain tumors.pdfDRVIKASHKR
Β 
Neuro-Oncology for the Radiation Oncologist - Gliomas
Neuro-Oncology for the Radiation Oncologist - GliomasNeuro-Oncology for the Radiation Oncologist - Gliomas
Neuro-Oncology for the Radiation Oncologist - GliomasEmil Lou, M.D., Ph.D, FACP
Β 
Perspective: Imaging for Gliomas
Perspective: Imaging for GliomasPerspective: Imaging for Gliomas
Perspective: Imaging for Gliomasasclepiuspdfs
Β 
Propranolol and Neuro storming.pptx
Propranolol and Neuro storming.pptxPropranolol and Neuro storming.pptx
Propranolol and Neuro storming.pptxAnnaSandler4
Β 
Quantec dr. upasna saxena (2)
Quantec   dr. upasna saxena (2)Quantec   dr. upasna saxena (2)
Quantec dr. upasna saxena (2)Upasna Saxena
Β 
Precision Medicine in Acute Brain Injury
Precision Medicine in Acute Brain InjuryPrecision Medicine in Acute Brain Injury
Precision Medicine in Acute Brain InjurySMACC Conference
Β 
Autologous Bone Marrow Cell Therapy for Autism: An Open Label Uncontrolled C...
Autologous Bone Marrow Cell Therapy for Autism: An  Open Label Uncontrolled C...Autologous Bone Marrow Cell Therapy for Autism: An  Open Label Uncontrolled C...
Autologous Bone Marrow Cell Therapy for Autism: An Open Label Uncontrolled C...remedypublications2
Β 
Papillary Glioneuronal Tumor of Third Ventricle Endoscopically Treated: Case ...
Papillary Glioneuronal Tumor of Third Ventricle Endoscopically Treated: Case ...Papillary Glioneuronal Tumor of Third Ventricle Endoscopically Treated: Case ...
Papillary Glioneuronal Tumor of Third Ventricle Endoscopically Treated: Case ...semualkaira
Β 
ClinicalOutcomesFollowingCoronary BifurcationPCITechniques.pdf
ClinicalOutcomesFollowingCoronary BifurcationPCITechniques.pdfClinicalOutcomesFollowingCoronary BifurcationPCITechniques.pdf
ClinicalOutcomesFollowingCoronary BifurcationPCITechniques.pdfIrving Torres Lopez
Β 
NET Theranostics Research Poster
NET Theranostics Research PosterNET Theranostics Research Poster
NET Theranostics Research PosterIan Alexander
Β 
Newer management techniques for glioblastoma
Newer management techniques for glioblastomaNewer management techniques for glioblastoma
Newer management techniques for glioblastomaabhitux
Β 
Can brain atrophy measurement help us in monitoring MS progression in routine...
Can brain atrophy measurement help us in monitoring MS progression in routine...Can brain atrophy measurement help us in monitoring MS progression in routine...
Can brain atrophy measurement help us in monitoring MS progression in routine...MS Trust
Β 
Management of Primary CNS Lymphoma (PCNSL)
Management of Primary CNS Lymphoma (PCNSL)Management of Primary CNS Lymphoma (PCNSL)
Management of Primary CNS Lymphoma (PCNSL)Narayan Adhikari
Β 
Diabetic retinopathy management an advanced approach gonzalez
Diabetic retinopathy management an advanced approach gonzalezDiabetic retinopathy management an advanced approach gonzalez
Diabetic retinopathy management an advanced approach gonzalezDiopsys, Inc.
Β 

Similar to Hartings, Jed - Outcome (20)

Terrando et al-2015-anesthesia_&_analgesia
Terrando et al-2015-anesthesia_&_analgesiaTerrando et al-2015-anesthesia_&_analgesia
Terrando et al-2015-anesthesia_&_analgesia
Β 
Dr Vikash_re irradiation_brain tumors.pdf
Dr Vikash_re irradiation_brain tumors.pdfDr Vikash_re irradiation_brain tumors.pdf
Dr Vikash_re irradiation_brain tumors.pdf
Β 
Rescue icp
Rescue icpRescue icp
Rescue icp
Β 
Neuro-Oncology for the Radiation Oncologist - Gliomas
Neuro-Oncology for the Radiation Oncologist - GliomasNeuro-Oncology for the Radiation Oncologist - Gliomas
Neuro-Oncology for the Radiation Oncologist - Gliomas
Β 
Perspective: Imaging for Gliomas
Perspective: Imaging for GliomasPerspective: Imaging for Gliomas
Perspective: Imaging for Gliomas
Β 
Propranolol and Neuro storming.pptx
Propranolol and Neuro storming.pptxPropranolol and Neuro storming.pptx
Propranolol and Neuro storming.pptx
Β 
Quantec dr. upasna saxena (2)
Quantec   dr. upasna saxena (2)Quantec   dr. upasna saxena (2)
Quantec dr. upasna saxena (2)
Β 
Precision Medicine in Acute Brain Injury
Precision Medicine in Acute Brain InjuryPrecision Medicine in Acute Brain Injury
Precision Medicine in Acute Brain Injury
Β 
Effect of Transcranial Low-Level Light Therapy vs Sham Therapy Among Patients...
Effect of Transcranial Low-Level Light Therapy vs Sham Therapy Among Patients...Effect of Transcranial Low-Level Light Therapy vs Sham Therapy Among Patients...
Effect of Transcranial Low-Level Light Therapy vs Sham Therapy Among Patients...
Β 
Autologous Bone Marrow Cell Therapy for Autism: An Open Label Uncontrolled C...
Autologous Bone Marrow Cell Therapy for Autism: An  Open Label Uncontrolled C...Autologous Bone Marrow Cell Therapy for Autism: An  Open Label Uncontrolled C...
Autologous Bone Marrow Cell Therapy for Autism: An Open Label Uncontrolled C...
Β 
neurosurgery
neurosurgeryneurosurgery
neurosurgery
Β 
Papillary Glioneuronal Tumor of Third Ventricle Endoscopically Treated: Case ...
Papillary Glioneuronal Tumor of Third Ventricle Endoscopically Treated: Case ...Papillary Glioneuronal Tumor of Third Ventricle Endoscopically Treated: Case ...
Papillary Glioneuronal Tumor of Third Ventricle Endoscopically Treated: Case ...
Β 
ClinicalOutcomesFollowingCoronary BifurcationPCITechniques.pdf
ClinicalOutcomesFollowingCoronary BifurcationPCITechniques.pdfClinicalOutcomesFollowingCoronary BifurcationPCITechniques.pdf
ClinicalOutcomesFollowingCoronary BifurcationPCITechniques.pdf
Β 
NET Theranostics Research Poster
NET Theranostics Research PosterNET Theranostics Research Poster
NET Theranostics Research Poster
Β 
Newer management techniques for glioblastoma
Newer management techniques for glioblastomaNewer management techniques for glioblastoma
Newer management techniques for glioblastoma
Β 
Can brain atrophy measurement help us in monitoring MS progression in routine...
Can brain atrophy measurement help us in monitoring MS progression in routine...Can brain atrophy measurement help us in monitoring MS progression in routine...
Can brain atrophy measurement help us in monitoring MS progression in routine...
Β 
Management of Primary CNS Lymphoma (PCNSL)
Management of Primary CNS Lymphoma (PCNSL)Management of Primary CNS Lymphoma (PCNSL)
Management of Primary CNS Lymphoma (PCNSL)
Β 
2012, Veeravagu, et al, IM SC Mets, Contemp NS
2012, Veeravagu, et al, IM SC Mets, Contemp NS2012, Veeravagu, et al, IM SC Mets, Contemp NS
2012, Veeravagu, et al, IM SC Mets, Contemp NS
Β 
Glaucoma
GlaucomaGlaucoma
Glaucoma
Β 
Diabetic retinopathy management an advanced approach gonzalez
Diabetic retinopathy management an advanced approach gonzalezDiabetic retinopathy management an advanced approach gonzalez
Diabetic retinopathy management an advanced approach gonzalez
Β 

More from National Neurotrauma Symposium (20)

Zafonte, Ross
Zafonte, RossZafonte, Ross
Zafonte, Ross
Β 
Youcha, Vicki
Youcha, VickiYoucha, Vicki
Youcha, Vicki
Β 
Yonas, Howard
Yonas, HowardYonas, Howard
Yonas, Howard
Β 
Ungerstedt, Urban
Ungerstedt, UrbanUngerstedt, Urban
Ungerstedt, Urban
Β 
Timmons, Shelly
Timmons, ShellyTimmons, Shelly
Timmons, Shelly
Β 
Svetlov, Stanislav
Svetlov, StanislavSvetlov, Stanislav
Svetlov, Stanislav
Β 
Sullivan, Patrick
Sullivan, PatrickSullivan, Patrick
Sullivan, Patrick
Β 
Stewart, William
Stewart, WilliamStewart, William
Stewart, William
Β 
Snyder, Evan
Snyder, EvanSnyder, Evan
Snyder, Evan
Β 
Smith, Doug H. - handout
Smith, Doug H. - handoutSmith, Doug H. - handout
Smith, Doug H. - handout
Β 
Smith, Doug H.
Smith, Doug H.Smith, Doug H.
Smith, Doug H.
Β 
Sanchez, Justin
Sanchez, JustinSanchez, Justin
Sanchez, Justin
Β 
Rowitch, David
Rowitch, DavidRowitch, David
Rowitch, David
Β 
Rezai, Ali
Rezai, AliRezai, Ali
Rezai, Ali
Β 
Razumovsky, Alexander
Razumovsky, AlexanderRazumovsky, Alexander
Razumovsky, Alexander
Β 
Povlishock, John
Povlishock, JohnPovlishock, John
Povlishock, John
Β 
Peckham, Hunter
Peckham, HunterPeckham, Hunter
Peckham, Hunter
Β 
Widerstrom noga talk 7-12_11
Widerstrom noga talk 7-12_11Widerstrom noga talk 7-12_11
Widerstrom noga talk 7-12_11
Β 
Noble, Marc
Noble, MarcNoble, Marc
Noble, Marc
Β 
Mukherjee, Pratik
Mukherjee, PratikMukherjee, Pratik
Mukherjee, Pratik
Β 

Recently uploaded

Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
Β 
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...Neha Kaur
Β 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...narwatsonia7
Β 
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
Β 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Servicevidya singh
Β 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
Β 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
Β 
Night 7k to 12k Navi Mumbai Call Girl Photo πŸ‘‰ BOOK NOW 9833363713 πŸ‘ˆ ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo πŸ‘‰ BOOK NOW 9833363713 πŸ‘ˆ ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo πŸ‘‰ BOOK NOW 9833363713 πŸ‘ˆ ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo πŸ‘‰ BOOK NOW 9833363713 πŸ‘ˆ ♀️ night ...aartirawatdelhi
Β 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
Β 
VIP Call Girls Indore Kirti πŸ’šπŸ˜‹ 9256729539 πŸš€ Indore Escorts
VIP Call Girls Indore Kirti πŸ’šπŸ˜‹  9256729539 πŸš€ Indore EscortsVIP Call Girls Indore Kirti πŸ’šπŸ˜‹  9256729539 πŸš€ Indore Escorts
VIP Call Girls Indore Kirti πŸ’šπŸ˜‹ 9256729539 πŸš€ Indore Escortsaditipandeya
Β 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsGfnyt
Β 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
Β 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...chandars293
Β 
VIP Service Call Girls Sindhi Colony πŸ“³ 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony πŸ“³ 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony πŸ“³ 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony πŸ“³ 7877925207 For 18+ VIP Call Girl At Th...jageshsingh5554
Β 
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...narwatsonia7
Β 
The Most Attractive Hyderabad Call Girls Kothapet π– ‹ 6297143586 π– ‹ Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet π– ‹ 6297143586 π– ‹ Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet π– ‹ 6297143586 π– ‹ Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet π– ‹ 6297143586 π– ‹ Will You Mis...chandars293
Β 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomdiscovermytutordmt
Β 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escortsvidya singh
Β 
Russian Escorts Girls Nehru Place ZINATHI πŸ”9711199012 β˜ͺ 24/7 Call Girls Delhi
Russian Escorts Girls  Nehru Place ZINATHI πŸ”9711199012 β˜ͺ 24/7 Call Girls DelhiRussian Escorts Girls  Nehru Place ZINATHI πŸ”9711199012 β˜ͺ 24/7 Call Girls Delhi
Russian Escorts Girls Nehru Place ZINATHI πŸ”9711199012 β˜ͺ 24/7 Call Girls DelhiAlinaDevecerski
Β 

Recently uploaded (20)

Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Β 
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...
Β 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Β 
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Β 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Β 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Β 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Β 
Night 7k to 12k Navi Mumbai Call Girl Photo πŸ‘‰ BOOK NOW 9833363713 πŸ‘ˆ ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo πŸ‘‰ BOOK NOW 9833363713 πŸ‘ˆ ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo πŸ‘‰ BOOK NOW 9833363713 πŸ‘ˆ ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo πŸ‘‰ BOOK NOW 9833363713 πŸ‘ˆ ♀️ night ...
Β 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Β 
VIP Call Girls Indore Kirti πŸ’šπŸ˜‹ 9256729539 πŸš€ Indore Escorts
VIP Call Girls Indore Kirti πŸ’šπŸ˜‹  9256729539 πŸš€ Indore EscortsVIP Call Girls Indore Kirti πŸ’šπŸ˜‹  9256729539 πŸš€ Indore Escorts
VIP Call Girls Indore Kirti πŸ’šπŸ˜‹ 9256729539 πŸš€ Indore Escorts
Β 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Β 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Β 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Β 
Russian Call Girls in Delhi Tanvi ➑️ 9711199012 πŸ’‹πŸ“ž Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➑️ 9711199012 πŸ’‹πŸ“ž Independent Escort Service...Russian Call Girls in Delhi Tanvi ➑️ 9711199012 πŸ’‹πŸ“ž Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➑️ 9711199012 πŸ’‹πŸ“ž Independent Escort Service...
Β 
VIP Service Call Girls Sindhi Colony πŸ“³ 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony πŸ“³ 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony πŸ“³ 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony πŸ“³ 7877925207 For 18+ VIP Call Girl At Th...
Β 
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
Β 
The Most Attractive Hyderabad Call Girls Kothapet π– ‹ 6297143586 π– ‹ Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet π– ‹ 6297143586 π– ‹ Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet π– ‹ 6297143586 π– ‹ Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet π– ‹ 6297143586 π– ‹ Will You Mis...
Β 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Β 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Β 
Russian Escorts Girls Nehru Place ZINATHI πŸ”9711199012 β˜ͺ 24/7 Call Girls Delhi
Russian Escorts Girls  Nehru Place ZINATHI πŸ”9711199012 β˜ͺ 24/7 Call Girls DelhiRussian Escorts Girls  Nehru Place ZINATHI πŸ”9711199012 β˜ͺ 24/7 Call Girls Delhi
Russian Escorts Girls Nehru Place ZINATHI πŸ”9711199012 β˜ͺ 24/7 Call Girls Delhi
Β 

Hartings, Jed - Outcome

  • 1. Cortical spreading depolarizations are a novel mechanism independently associated with unfavorable clinical outcome in TBI Jed Hartings, PhD Department of Neurosurgery University of Cincinnati [email_address] 513-558-3567 COSBID
  • 2.
  • 3.
  • 4.
  • 5.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12. Results No differences in recording durations (p>0.50), timing of surgery (p>0.50), or prognostic scores (p=0.34). Significant difference in outcome between depolarization categories Ο‡ 2 , p<0.01 Poor outcome (dead, VS, severe disability) ISD CSD None Poor outcome More likely Less likely Prognostic scores
  • 13. Results *p=0.26 ^p<0.001 Multivariate ordinal regression analysis Estimated common odds ratio 95% confidence interval p-value Prognostic Score 1.76 1.26 to 2.46 <0.001 Depolarization None 1.0 reference <0.001 CSD 1.56* 0.72 to 3.37 ISD 7.58^ 2.64 to 21.8 Depolarization No 1.0 reference 0.01 Yes 2.55 1.25 to 5.20
  • 14.
  • 15.
  • 16. Acknowledgments Ross Bullock – Miami, FL David Okonkwo – Pittsburgh, PA Lilian Murray – Glasgow, Scotland Gordon Murray – Glasgow, Scotland Martin Fabricius – Copenhagen, Denmark Andrew Maas – Edegem, Belgium Johannes Woitzik – Berlin, Germany Oliver Sakowitz – Heidelberg, Germany Bruce Mathern – Richmond, VA Bob Roozenbeek – Rotterdam, Netherlands Hester Lingsma – Rotterdam, Netherlands Jens Dreier – Berlin, Germany Ava Puccio – Pittsburgh, PA Lori Shutter – Cincinnati, OH Clemens Pahl – London, UK Anthony Strong – London, UK COSBID U.S. Army CDMRP PH/TBI Research Program, Contract No. W81XWH-08-2-0016