University of Cincinnati researchers are looking deep inside the brain to figure out why some head injury patients recover and others do not.
It appears linked to what's called a "brain tsunami," or damaging, seizure-like waves that spread slowly through the brain following a traumatic injury. Eventually doctors hope to prevent this wave of secondary damage. But the first step is to come up with a good way to identify when a patient is having a brain tsunami.
This is a recording of brain electrical activity, played back at 44x normal rate, in a patient who suffered a traumatic head injury. The cracking sound is the normal activity of brain cells; the periods of silence are short-circuits of electrical activity caused by brain tsunamis, waves of depolarization that spread across injured areas of the brain, causing a local loss of function.
The U.S. Department of Defense has awarded Jed Hartings, PhD, research associate professor in the Department of Neurosurgery at the UC College of Medicine, a $4.7 million grant to study the damaging waves, by investigating less invasive techniques to monitor them. Doctors will surgically implant monitoring electrodes directly on the brain and a second set on the scalp in the form of a non-invasive cap.
Brain surgeon Dr. Laura Ngwenya, MD, PhD, says this means the cap, producing an electroencephalogram (EEG), would open up brain tsunami monitoring to a much wider variety of patients. "Once we are able to come up with a way, we can use the scalp electrodes to be able to look at this in a new normal population, a population of brain traumatic injured patients that don't need surgery that will help us have more information."
Hartings' research shows 60 percent of the most serious head injury patients who require surgery have brain tsunamis.
UC is leading the study that also includes Baylor College of Medicine, Massachusetts General Hospital/Harvard University, the University of California San Francisco, the University of Pittsburgh and the University of Miami.
Following the study Hartings will come up with an algorithm to evaluate all the data. He says, "We have huge quantities of data that will all live in the cloud and will be exchanged between various analysis teams."
Results from this study could make EEG monitoring standard for all brain trauma intensive care patients and others, such as stroke victims. Hartings says almost anyone who has a severe stroke has a brain tsunami.