Clinical outcomes and thermodynamics aspect of direct brain cooling in severe head injury

Abstract

Background: Brain cooling therapy is one of the subjects of interest, and currently, data on direct brain cooling are lacking. Hence, the objective is to investigate the clinical outcomes and discuss the thermodynamics aspect of direct brain cooling on severely injured brain patients. Methods: This pilot study recruited the severely injured brain patients who were then randomized to either a direct brain cooling therapy group using a constant cooling temperature system or a control group. All studied patients must be subjected to an emergency neurosurgical procedure of decompressive craniectomy and were monitored with intracranial pressure, brain oxygenation, and temperature. Further, comparison was made with our historical group of patients who had direct brain cooling therapy through the old technique. Results: The results disclosed the direct brain cooling treated patients through a newer technique obtained a better Extended Glasgow Outcome Score than a control group (P < 001). In addition, there is a significant outcome difference between the combined cooling treated patients (new and old technique) with the control group (P < 0.001). Focal brain oxygenation and temperature are likely factors that correlate with better outcomes. Conclusion: Direct brain cooling is feasible, safe, and affects the clinical outcomes of the severely traumatized brain, and physics of thermodynamics may play a role in its pathophysiology.

Light and Brain: A Clinical Case Depicting the Effects of Light on Brainwaves and Possible Presence of Plasma-Like Brain Energy.

“…Low entropy system has a concentrated energy state, whilst high entropy system has spread-out energy state. It seems fitting with research findings that the deep brain nuclei and brainstem have warmer temperatures than the cortices [19][20][21]. It tells us directionality or gradient of energy flow from low entropy area such as the brainstem (concentrated energy) to high entropy area such as the cortex (spread-out energy).…”

Light and the Brain: A Clinical Case Depicting the Effects of Light on Brainwaves and Possible Presence of Plasma-like Brain Energy

“…A low-entropy system has a concentrated energy state, whilst a high-entropy system has a spread-out energy state. It seems fitting with the research findings that the deep brain nuclei and brainstem have warmer temperatures than the cortices [22][23][24]. It tells us the directionality or gradient of energy flow from a low-entropy area such as the brainstem (concentrated energy) to a high-entropy area such as the cortex (spread-out energy).…”

“…Thus, the represented colored lines on y-axis denote the following: a red line as 0.01; a black-dashed line as 1, and a black line as 100 uV 2 /Hz. For the brainwave spectra (colored boxes): red represents delta waves [0.5-4 Hz], yellow represents theta waves [4][5][6][7][8], green represents alpha waves [8][9][10][11][12], and blue represents beta waves [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30].…”