Cortical spreading depolarizations (SD) are strongly associated with worse tissue injury and clinical outcomes in the setting of aneurysmal subarachnoid hemorrhage (SAH). Animal studies have suggested a causal relationship, and new therapies to target SDs are starting to be tested in clinical studies. A recent set of single-center randomized trials assessed the effect of the phosphodiesterase inhibitor cilostazol in patients with SAH. Cilostazol led to improved functional outcomes and SD-related metrics in treated patients through a putative mechanism of improved cerebral blood flow. Another promising therapeutic approach includes attempts to block SDs with, for example, the NMDA receptor antagonist ketamine. SDs have emerged not only as a therapeutic target but also as a potentially useful biomarker for brain injury following SAH. Additional clinical and preclinical experimental work is greatly needed to assess the generalizability of existing therapeutic trials and to better delineate the relationship between SDs, SAH, and functional outcome.

中文翻译：

---

扩散去极化和蛛网膜下腔出血。


皮质扩散去极化（SD）与动脉瘤性蛛网膜下腔出血（SAH）情况下更严重的组织损伤和临床结果密切相关。动物研究表明存在因果关系，针对 SD 的新疗法正开始在临床研究中进行测试。最近的一组单中心随机试验评估了磷酸二酯酶抑制剂西洛他唑对 SAH 患者的疗效。西洛他唑通过改善脑血流量的推定机制改善了治疗患者的功能结果和 SD 相关指标。另一种有希望的治疗方法包括尝试用 NMDA 受体拮抗剂氯胺酮等来阻断 SD。 SD 不仅成为治疗靶点，而且还成为 SAH 后脑损伤的潜在有用生物标志物。非常需要额外的临床和临床前实验工作来评估现有治疗试验的普遍性，并更好地描述 SD、SAH 和功能结果之间的关系。