La despolarización cortical propagada en trauma cerebral

Abstract

CSD is a wave of depolarization in neuronal and glial cells that propagates in the gray matter of the cerebral cortex initially described by Leão in 1994. In the presence of cerebral injury, ion pumps fail and the efflux current becomes insufficient producing sustained depolarization, electrical inactivity, cytosolic hyperosmolarity accompanied by dendritic changes and cytotoxic edema. CSD has been evidenced by the addition of potassium, glutamate and acetylcholine or activation of astrocytes, in addition, it also occurs in hypoxia, migraine, hypoglycaemia, infarction, subarachnoid hemorrhage, convulsive states and brain trauma, which leads to an expansion of the focal damage. The therapeutic approach is not yet fully established, however, inhibitors of NMDA receptors are used, since it can counteract the onset and spread of CSD.