Clusters of cortical spreading depression are the electrocorticographic correlate of delayed ischemic neurological deficits after subarachnoid hemorrhage

Background: It has been proposed that spreading depression (SD) is a key component of delayed ischemic neurological deficit (DIND) after subarachnoid hemorrhage (SAH) based on (1) the predominant pathomorphological pattern in the autopsy studies consisting of widespread necroses confined to the cortical compartment which cross the boundaries of the vascular territories, (2) the characteristic waxing and waning clinical presentation of the neurological syndrome and (3) animal research. Methods: Eighteen patients with aneurysmal SAH undergoing open surgical treatment were consecutively recruited by four centers of…