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Bridging the Gap: Translating Microemboli-Induced Spreading Depolarization Into Clinical Practice.

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Title: Bridging the Gap: Translating Microemboli-Induced Spreading Depolarization Into Clinical Practice.
Authors: Brammer Kreiberg MP; Department of Neurology, Copenhagen University Hospital - Herlev and Gentofte, Denmark., Hamann S; Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet, Denmark.; Department of Clinical Medicine, University of Copenhagen, Denmark.; Rothschild Foundation Hospital, Paris, France., Rosenbaum S; Department of Neurology, Copenhagen University Hospital - Bispebjerg and Frederiksberg Hospital, Denmark., Rossing K; Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Denmark., Gall MA; Medical & Translational Science, Diabetes, Cardiovascular, Liver & Rare Disease, Novo Nordisk A/S, Soeborg, Denmark; and., Ayata C; Neurovascular Research Unit, Department of Neurology, Massachusetts General Hospital, Charlestown., Hougaard A; Department of Neurology, Copenhagen University Hospital - Herlev and Gentofte, Denmark.; Department of Clinical Medicine, University of Copenhagen, Denmark.
Source: Neurology [Neurology] 2026 Oct 13; Vol. 107 (7), pp. e218484. Date of Electronic Publication: 2026 Aug 28.
Publication Type: Case Reports; Journal Article
Language: English
Journal Info: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0401060 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1526-632X (Electronic) Linking ISSN: 00283878 NLM ISO Abbreviation: Neurology Subsets: MEDLINE
Imprint Name(s): Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Minneapolis.
MeSH Terms: Intracranial Embolism*/complications , Intracranial Embolism*/physiopathology , Intracranial Embolism*/diagnostic imaging , Cortical Spreading Depression*/physiology , Migraine with Aura*/etiology , Migraine with Aura*/physiopathology , Migraine with Aura*/diagnostic imaging, Humans ; Female ; Aged ; Ultrasonography, Doppler, Transcranial
Abstract: A 68-year-old woman developed daily episodes of migraine aura following mitral valve surgery. During aura symptoms, microemboli in the posterior circulation were detected in real time by transcranial Doppler. After initiation of antiplatelet therapy, the daily clinical episodes ceased, and microemboli were not detectable on repeated transcranial Doppler. Spreading depolarization, the underlying mechanism of migraine aura symptoms, is a conserved electrophysiologic phenomenon characterized by a propagating wave of neuronal and glial depolarization. Experimental models demonstrate that spreading depolarization can be triggered by cortical ischemic lesions and by air emboli, cholesterol crystals, or microspheres in the cerebral circulation without apparent tissue injury. This case illustrates cerebral microembolism-triggered clinical episodes suggestive of cortical spreading depolarization. We therefore suggest that transient neurologic episodes with the characteristics of cortical spreading depolarization, that is, sequential, retinotopically or somatotopically spreading, neurologic symptoms with positive features, can be induced by microembolism in humans.
Entry Date(s): Date Created: 20260828 Date Completed: 20260828 Latest Revision: 20260828
Update Code: 20260829
DOI: 10.1212/WNL.0000000000218484
PMID: 42664477
Database: MEDLINE
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  Data: Bridging the Gap: Translating Microemboli-Induced Spreading Depolarization Into Clinical Practice.
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  Data: <searchLink fieldCode="AU" term="%22Brammer+Kreiberg+MP%22">Brammer Kreiberg MP</searchLink>; Department of Neurology, Copenhagen University Hospital - Herlev and Gentofte, Denmark.<br /><searchLink fieldCode="AU" term="%22Hamann+S%22">Hamann S</searchLink>; Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet, Denmark.; Department of Clinical Medicine, University of Copenhagen, Denmark.; Rothschild Foundation Hospital, Paris, France.<br /><searchLink fieldCode="AU" term="%22Rosenbaum+S%22">Rosenbaum S</searchLink>; Department of Neurology, Copenhagen University Hospital - Bispebjerg and Frederiksberg Hospital, Denmark.<br /><searchLink fieldCode="AU" term="%22Rossing+K%22">Rossing K</searchLink>; Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Denmark.<br /><searchLink fieldCode="AU" term="%22Gall+MA%22">Gall MA</searchLink>; Medical & Translational Science, Diabetes, Cardiovascular, Liver & Rare Disease, Novo Nordisk A/S, Soeborg, Denmark; and.<br /><searchLink fieldCode="AU" term="%22Ayata+C%22">Ayata C</searchLink>; Neurovascular Research Unit, Department of Neurology, Massachusetts General Hospital, Charlestown.<br /><searchLink fieldCode="AU" term="%22Hougaard+A%22">Hougaard A</searchLink>; Department of Neurology, Copenhagen University Hospital - Herlev and Gentofte, Denmark.; Department of Clinical Medicine, University of Copenhagen, Denmark.
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  Data: <searchLink fieldCode="JN" term="%220401060%22">Neurology</searchLink> [Neurology] 2026 Oct 13; Vol. 107 (7), pp. e218484. <i>Date of Electronic Publication: </i>2026 Aug 28.
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  Data: Case Reports; Journal Article
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Lippincott+Williams+%26+Wilkins%22">Lippincott Williams & Wilkins </searchLink><i>Country of Publication: </i>United States <i>NLM ID: </i>0401060 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1526-632X (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2200283878%22">00283878 </searchLink><i>NLM ISO Abbreviation: </i>Neurology <i>Subsets: </i>MEDLINE
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  Data: <i>Publication</i>: Hagerstown, MD : Lippincott Williams & Wilkins<br /><i>Original Publication</i>: Minneapolis.
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  Data: <searchLink fieldCode="MM" term="%22Intracranial+Embolism%22">Intracranial Embolism*</searchLink>/<searchLink fieldCode="MM" term="%22Intracranial+Embolism+complications%22">complications</searchLink> <br /><searchLink fieldCode="MM" term="%22Intracranial+Embolism%22">Intracranial Embolism*</searchLink>/<searchLink fieldCode="MM" term="%22Intracranial+Embolism+physiopathology%22">physiopathology</searchLink> <br /><searchLink fieldCode="MM" term="%22Intracranial+Embolism%22">Intracranial Embolism*</searchLink>/<searchLink fieldCode="MM" term="%22Intracranial+Embolism+diagnostic+imaging%22">diagnostic imaging</searchLink> <br /><searchLink fieldCode="MM" term="%22Cortical+Spreading+Depression%22">Cortical Spreading Depression*</searchLink>/<searchLink fieldCode="MM" term="%22Cortical+Spreading+Depression+physiology%22">physiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Migraine+with+Aura%22">Migraine with Aura*</searchLink>/<searchLink fieldCode="MM" term="%22Migraine+with+Aura+etiology%22">etiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Migraine+with+Aura%22">Migraine with Aura*</searchLink>/<searchLink fieldCode="MM" term="%22Migraine+with+Aura+physiopathology%22">physiopathology</searchLink> <br /><searchLink fieldCode="MM" term="%22Migraine+with+Aura%22">Migraine with Aura*</searchLink>/<searchLink fieldCode="MM" term="%22Migraine+with+Aura+diagnostic+imaging%22">diagnostic imaging</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Aged%22">Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Ultrasonography%2C+Doppler%2C+Transcranial%22">Ultrasonography, Doppler, Transcranial</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: A 68-year-old woman developed daily episodes of migraine aura following mitral valve surgery. During aura symptoms, microemboli in the posterior circulation were detected in real time by transcranial Doppler. After initiation of antiplatelet therapy, the daily clinical episodes ceased, and microemboli were not detectable on repeated transcranial Doppler. Spreading depolarization, the underlying mechanism of migraine aura symptoms, is a conserved electrophysiologic phenomenon characterized by a propagating wave of neuronal and glial depolarization. Experimental models demonstrate that spreading depolarization can be triggered by cortical ischemic lesions and by air emboli, cholesterol crystals, or microspheres in the cerebral circulation without apparent tissue injury. This case illustrates cerebral microembolism-triggered clinical episodes suggestive of cortical spreading depolarization. We therefore suggest that transient neurologic episodes with the characteristics of cortical spreading depolarization, that is, sequential, retinotopically or somatotopically spreading, neurologic symptoms with positive features, can be induced by microembolism in humans.
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  Data: <i>Date Created: </i>20260828 <i>Date Completed: </i>20260828 <i>Latest Revision: </i>20260828
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        Text: English
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      – SubjectFull: Ultrasonography, Doppler, Transcranial
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      – SubjectFull: Intracranial Embolism complications
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      – SubjectFull: Intracranial Embolism diagnostic imaging
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      – SubjectFull: Cortical Spreading Depression physiology
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      – SubjectFull: Migraine with Aura etiology
        Type: general
      – SubjectFull: Migraine with Aura physiopathology
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      – TitleFull: Bridging the Gap: Translating Microemboli-Induced Spreading Depolarization Into Clinical Practice.
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              Text: 2026 Oct 13
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