tissue and on this path become increasingly
transient and thus innocuous. Their wide
propagation from ischemic or metabolically
stressed zones into healthy, surrounding
tissue renders them highly attractive as a
biomarker for cerebral injury, because regional
electrocorticographic monitoring affords even
remote detection of newly developing injury.
The iCSD meeting in Berlin on March
29-31, 2017, attracted 120 clinicians and
basic scientists of various disciplines
from 19 countries. In accordance with the
organizers’ vision, more than half of the oral
presentations were from first-time attendees
to the conference. Furthermore, the meeting
content was split equally between laboratory
and clinical studies, though often combined
in the same sessions. A clinical highlight was
the presentation from Yamaguchi University,
Japan, on electrocorticographic monitoring
of 43 patients enrolled at their center in the
cilostazol trial for treatment of aSAH. They found
a significant association of spreading depolarizations with
delayed cerebral ischemia, with high positive and negative
predictive values. Another highlight was a positive result in a pilot
clinical study of the effects of ketamine to suppress spreading
depolarizations. In the basic sciences, two-photon imaging and
electron microscopy revealed dendritic beading, disordered
microtubules, and fragmented mitochondria and endoplasmic
reticulum triggered by spreading depolarization. Other talks
highlighted the links between depolarizations, blood-brain barrier
disruption and epilepsy. The Uwe Heineman Young Investigator
Prize was awarded to Lila Khennouf for her work describing
the role of capillary pericytes in blood flow changes induced by
depolarizations.
A hallmark of the iCSD — and past COSBID — meetings is the
extensive time allotted, or sometimes taken, for discussions. This
derives from the rapid advances in the field and also from the
fact that recorded data in humans and animals are remarkably
similar. Both clinicians and experimentalists can thus appreciate
and engage the same data, from synaptic ultrastructure to clinical
outcomes. This year’s meeting was similar and was capped by a
discussion of whether the participants would want their loved
ones to undergo electrocorticographic monitoring of spreading
depolarizations if they suffered a serious brain trauma or stroke.
While the initial vote was nearly unanimous in favor, it led to
important discussions of treatments, trials and current “standard
care” neuromonitoring.
The organizers thank all participants of
iCSD2017 and particularly the keynote
speakers. We invite members of the
Neurocritical Care Society to consider
attending and submitting their work to the
next iCSD meeting in 2018, as we look forward
to another vibrant, translational meeting.
1 Center for Stroke Research, Charité University Medicine Berlin,
Berlin, Germany
2 Department of Neurology, Charité University Medicine
Berlin, Berlin, Germany
3 Department of Experimental Neurology, Charité
University Medicine Berlin, Berlin, Germany
4 Department of Neurosurgery, University of
Cincinnati College of Medicine,
Cincinnati, OH, USA
5 Mayfield Clinic, Cincinnati, OH, USA
6 Department of Neurosurgery, Charité
University Medicine Berlin, Charitéplatz
1, 10117 Berlin, Germany
7 Department of Neurology,
Neurocritical Care, Medical
University of Innsbruck,
Innsbruck, Austria
9