A review of selective hypothermia in the management of traumatic brain injury

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>Traumatic brain injury (TBI) remains a significant cause of morbidity and death in the US and worldwide. Resuscitative systemic hypothermia following TBI has been established as an effective neuroprotective treatment in multiple studies in animals and humans, although this intervention carries with it a significant risk profile as well. Selective, or preferential, methods of inducing cerebral hypothermia have taken precedence over the past few years in order to minimize systemic adverse effects. In this report, the authors explore the current methods available for inducing selective cerebral hypothermia following TBI and review the literature regarding the results of animal and human trials in which these methods have been implemented.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>A search of the PubMed archive (National Library of Medicine) and the reference lists of all relevant articles was conducted to identify all animal and human studies pertaining to the use of selective brain cooling, selective hypothermia, preferential hypothermia, or regional hypothermia following TBI.</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Multiple methods of inducing selective cerebral hypothermia are currently in the experimental phases, including surface cooling, intranasal selective hypothermia, transarterial or transvenous endovascular cooling, extraluminal vascular cooling, and epidural cerebral cooling.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Several methods of conferring preferential neuroprotection via selective hypothermia currently are being tested. Class I prospective clinical trials are required to assess the safety and efficacy of these methods.</jats:p></jats:sec>

Therapeutic Potential of Cannabinoids in the Treatment of Neuroinflammation Associated with Parkinsons Disease

“…It is widely accepted that therapeutic hypothermia benefits the brain in numerous ways including decreased accumulation of excitotoxic neurotransmitters, suppression of reactive oxygen species (ROS) generation and reduction of mechanisms related to post-ischemic remodeling [67]. Therefore, multiple methods of inducing hypothermia including surface cooling, intranasal selective hypothermia, extraluminal vascular cooling and epidural cerebral cooling are currently being tested for efficacy and safety [68]. Therapeutic manipulation of body temperature by targeted use of cannabinoids may represent a novel means of slowing down the progression of chronic neurodegenerative diseases, which include PD and Alzheimer's disease Second, post mortem analysis show elevated levels of IL-1 and TNF-in the substantia nigra of PD patients; these pro-inflammatory cytokines have been implicated in the pathogenesis of PD (reviewed in [69]).…”

Cerebral oxygen metabolism and neuroelectrophysiology in a clinical study of severe brain injury and mild hypothermia

“…Hypothermia, as a treatment for brain injury, has been widely studied. [1][2][3][4][5][6][7] In this study, we have included a larger group of patients and refined the injury grouping to extend the results of our previous work. [8][9][10][11][12][13] In addition, indexes of cerebral oxygen metabolism and neuroelectrophysiology were monitored during hypothermia to evaluate the therapeutic effect of hypothermia on brain injury.…”

Hypothermia in Stroke Therapy: Systemic versus Local Application

“…Therapeutic cerebral hypothermia can be most easily established by either surface cooling or systemic endovascular infusion cold saline [11,12]. In clinical stroke cases, surface and endovascular cooling have both been used for successful whole-body hypothermia induction and maintenance.…”