Samuel Cramer
This is a preliminary, prospective interventional feasibility study to investigate the use of cortical reverberation (CR) monitoring in patients with traumatic brain injury (TBI) requiring a clinically indicated external ventricular drain (EVD) placement.
Traumatic brain injury (TBI) is a major cause of death and disability and imposes burden on the health-system and society. Beyond the first impact of the injury, secondary brain injury processes, include elevated intracranial pressure (ICP), impaired autoregulation, seizures, and cortical spreading depolarizations (CSDs). These effects drive lesion expansion and worsen outcomes. Observational cohorts show that CSDs are common after severe TBI and that higher CSD burden results in worse recovery. This is a preliminary, prospective interventional feasibility study to investigate the use of cort…
Inclusion Criteria: 1. 18 years or older 2. Consenting party must be able to provide written consent in English 3. Patient recommended to undergo EVD placement for the monitoring and possible treatment of ICP after TBI Exclusion Criteria: 1. Contaminated scalp lacerations 2. Known systemic infection 3. Non-English speaking 4. Fixed, uncorrectable coagulopathy 5. Pregnant, minors, or wards of the state
Placement of a multi-contact depth electrode through the same burr hole created with a twist drill for clinically indicated EVD placement in TBI patients. The electrode will be positioned adjacent to the EVD catheter and connected to a stimulator/recording system to deliver biphasic, charge- balanced pulses (1-6 mA, 60-1000 µs) between adjacent contacts less than or equal to once every 3 seconds (0.33 Hz) while recording evoked cortical reverberation responses.
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