PAINWeek Journal Premier Issue | Page 41

In 1944 Leão expressed his theory of CSD, a well-defined wave of neuronal excitation in the cortical gray matter spreading from the site of origin at an average of 4 mm per minute (range 2–6 mm/ min).33 The ensuing cellular depolarization causes the primary cortical phenomena (aura phase), the basis of which is the release of potassium or glutamate from neuronal tissue that depolarizes adjacent tissue, which in turn then releases more neurotransmitters and thus propagates the CSD. Positron emission tomography (