Selective hypothermia: an experimental study on traumatic brain injury in rats

Dvilevicius, Amylcar Edemilson; Prandini, Mirto Nelso

doi:10.1590/s0004-282x2008000300021

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Hypothermia has been evaluated under controlled conditions in various experimental methods of brain damage including TBI and temporary and permanent cerebral ischemia. [1][2][3]13,14 It has unequivocally been found to be a very potent neuroprotective method. However, hypothermia has not proven to be an overall benefit for patients affected by TBI in clinical studies because potentially protective effects were counteracted by systemic, particularly infectious, complications.…”

Section: Discussionmentioning

confidence: 99%

“…22 In small rodent models, surface cooling was reported to be especially effective for selectively lowering brain temperature after hemicraniectomy. 13,23 Forte et al found that surface cooling using ice packs led to a decrease of brain temperature from 37.1°C to 35.2°C in patients with a refractory elevation of ICP after hemicraniectomy. Unfortunately, the authors did not report the course of core temperature during the 12-hour cooling period.…”

Section: Discussionmentioning

confidence: 99%

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Selective Brain Cooling after Traumatic Brain Injury: Effects of Three Different Cooling Methods—Case Report

Westermaier

Nickl

Koehler

et al. 2016

J Neurol Surg A Cent Eur Neurosurg

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In experimental models of neuronal damage, therapeutic hypothermia proved to be a powerful neuroprotective method. In clinical studies of traumatic brain injury (TBI), this very distinct effect was not reproducible. Several meta-analyses draw different conclusions about whether therapeutic hypothermia can improve outcome after TBI. Adverse side effects of systemic hypothermia, such as severe pneumonia, have been held responsible by some authors to counteract the neuroprotective effect. Selective brain cooling (SBC) attempts to take advantage of the protective effects of therapeutic hypothermia without the adverse side effects of systemic hypothermia. Three different methods of SBC were applied in a patient who had severe TBI with recurrent increases of intracranial pressure (ICP) refractory to conventional forms of treatment: (1) external cooling of the scalp and neck using ice packs prior to hemicraniectomy, (2) external cooling of the craniectomy defect using ice packs after hemicraniectomy, and (3) cooling by epidural irrigation with cold Ringer solution after hemicraniectomy. External scalp cooling before hemicraniectomy, external cooling of the craniectomy defect, and epidural irrigation with cold fluid resulted in temperature differences (brain temperature to body temperature) of - 0.2°, - 0.7°, and - 3.6°C, respectively. ICP declined with decreasing brain temperature. Previous external cooling attempts for SBC faced the problem that brain temperature could not be lowered without a simultaneous decrease of systemic temperature. After hemicraniectomy, epidural irrigation with cold fluid may be a simple and effective way to lower ICP and apply one of the most powerful methods of cerebroprotection after severe TBI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Selective Brain Cooling after Traumatic Brain Injury: Effects of Three Different Cooling Methods—Case Report

Westermaier

Nickl

Koehler

et al. 2016

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

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Selective Brain Hypothermia Mitigates Brain Damage and Improves Neurological Outcome after Post-Traumatic Decompressive Craniectomy in Mice

Szczygielski

Müller

Mautes

et al. 2017

Journal of Neurotrauma

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Hypothermia and decompressive craniectomy (DC) have been considered as treatment for traumatic brain injury. The present study investigates whether selective brain hypothermia added to craniectomy could improve neurological outcome after brain trauma. Male CD-1 mice were assigned into the following groups: sham; DC; closed head injury (CHI); CHI followed by craniectomy (CHI+DC); and CHI+DC followed by focal hypothermia (CHI+DC+H). At 24 h post-trauma, animals were subjected to Neurological Severity Score (NSS) test and Beam Balance Score test. At the same time point, magnetic resonance imaging using a 9.4 Tesla scanner and subsequent volumetric evaluation of edema and contusion were performed. Thereafter, the animals were sacrificed and subjected to histopathological analysis. According to NSS, there was a significant impairment among all the groups subjected to trauma. Animals with both trauma and craniectomy performed significantly worse than animals with craniectomy alone. This deleterious effect disappeared when additional hypothermia was applied. BBS was significantly worse in the CHI and CHI+DC groups, but not in the CHI+DC+H group, compared to the sham animals. Edema and contusion volumes were significantly increased in CHI+DC animals, but not in the CHI+DC+H group, compared to the DC group. Histopathological analysis showed that neuronal loss and contusional blossoming could be attenuated by application of selective brain hypothermia. Selective brain cooling applied post-trauma and craniectomy improved neurological function and reduced structural damage and may be therefore an alternative to complication-burdened systemic hypothermia. Clinical studies are recommended in order to explore the potential of this treatment.

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Selective hypothermia: an experimental study on traumatic brain injury in rats

Cited by 2 publications

References 29 publications

Selective Brain Cooling after Traumatic Brain Injury: Effects of Three Different Cooling Methods—Case Report

Selective Brain Cooling after Traumatic Brain Injury: Effects of Three Different Cooling Methods—Case Report

Selective Brain Hypothermia Mitigates Brain Damage and Improves Neurological Outcome after Post-Traumatic Decompressive Craniectomy in Mice

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