Cortical spreading depolarization and ketamine: a short systematic review

Telles, João Paulo Mota; Welling, Leonardo C.; Coelho, Antônio Carlos Samaia da Silva; Rabelo, Ní­collas Nunes; Teixeira, Manoel Jacobsen; Figueiredo, Eberval Gadelha

doi:10.1016/j.neucli.2021.01.004

Cited by 14 publications

(12 citation statements)

References 54 publications

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“…[ 4 ] The role of ketamine in preventing delayed cerebral ischaemia through the suppression of cortical spreading depolarisations is also under evaluation. [ 5 ]…”

Section: A) Newer Advancements In Neuroanaesthesiamentioning

confidence: 99%

Recent advancements in the practice of neuroanaesthesia and neurocritical care: An update

et al. 2023

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The practice of neuroanaesthesia has expanded significantly in recent years to keep up with various challenges posed in the perioperative care of patients for neurosurgical, interventional, neuroradiological, and diagnostic procedures. Technological advancements in neuroscience include the intraoperative use of computed tomography scans and angiograms for vascular neurosurgery, magnetic resonance imaging, neuronavigation, expansion of minimally invasive neurosurgery, neuroendoscopy, stereotaxy, radiosurgery, the performance of increasingly complex procedures, advancements in neurocritical care, etc. Recent advancements in neuroanaesthesia that can meet these challenges include the resurgence of ketamine, opioid-free anaesthesia, total intravenous anaesthesia, techniques to facilitate intraoperative neuromonitoring, awake neurosurgical and spine surgeries, etc. The current review provides an update on the recent advancements in neuroanaesthesia and neurocritical care.

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“…[ 4 ] The role of ketamine in preventing delayed cerebral ischaemia through the suppression of cortical spreading depolarisations is also under evaluation. [ 5 ]…”

Section: A) Newer Advancements In Neuroanaesthesiamentioning

confidence: 99%

Recent advancements in the practice of neuroanaesthesia and neurocritical care: An update

et al. 2023

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“…Another important pathophysiological property ketamine offers in migraine management is its potential to decrease debilitation through dampening cortical spreading depression via glutamatergic NMDA receptor inhibition 21 . Cortical spreading depression is the predominant theory of auras in migraines and is described as a slow-moving propagated wave of depolarization that results in brain activity suppression 24 . With up to one-third of migraines influenced by auras 25 , the ability to target crippling symptoms and treat pain at the same time is efficacious.…”

Section: Ketamine Pharmacology and Pharmacokineticsmentioning

confidence: 99%

Ketamine Applications for Migraines: A Scoping Narrative Review

2023

AHM Journal

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In the United States alone, nearly 40 million children and adults suffer from migraines, which are the primary cause of morbidity, quality of life reduction, and loss of productivity for persons aged 15-49. Despite their global prevalence and various available treatment options, these disabilities are often still under-treated due to the individuality of treatment regimens and effect profiles. Compelling arguments have been made for ketamine use in opioid-sparing pain management. An increase in opioid stewardship, especially during the outbreak of the novel COVID-19, has only accentuated arguments for ketamine in migraine alleviation. However, within the last 20 years, the overall body of work addressing its role has not been clearly elucidated, with variations in optimal dosage and administration routes. Thus, this review aims to consolidate previous findings of ketamine as a migraine analgesic agent and to amass the most recent burgeoning data on its effectiveness in clinical settings. A comparison of intravenous, intranasal, and subcutaneous ketamine is examined, with a discussion on pharmacology, pharmacokinetics, and results in pain outcomes analyzed.

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“…e ideas of such drug applications are usually derived from redefining the basic science of the disease, then targeting certain critical factors that studies revealed with possible drugs. [9] . However, the clinical usage of such drugs in treating such patients may face resistance in the scientific communities and the public.…”

Section: Controversiesmentioning

confidence: 99%

“…For instance, the application of ketamine in the management of cortical spreading depolarization waves that pathologically occur following specific conditions, including traumatic brain injury, subarachnoid hemorrhage, cluster migraines, and migraine headaches. [ 9 ] Although ketamine has anti-inflammatory, antidepressant, and analgesic effects, its primary action is inhibiting N-methyl-d-aspartate receptors, halting the continuous and excessive flow of afferent impulses generated in injured tissues. Therefore, it may counteract the pathological spreading of depolarization waves in the affected brain.…”

Section: Controversiesmentioning

confidence: 99%