Traumatic Brain Injury

  • 1.4 million new traumatic brain injuries each year1:  50,000 die, 235,000 are hospitalized, and 1.1 million are treated and released from an emergency department
  • Caused by a blow/jolt to the head or by penetrating injury such as a gunshot wound
  • Two types of injuries to brain tissue occur
    • Primary Injury:  damage to brain structures and neuron that occurs with the initial impact
    • Secondary Injury:  biochemical events that occur after the primary injury that may have a devastating effect on outcome
  • Hypothermia is a very promising therapy to prevent/minimize damage from the secondary injury biochemical cascade
    • Full body cooling improved outcome significantly in patients less than 45 years of age that were also hypothermic on admission2,3
    • Several small studies have shown improved outcome with full body cooling4,5
  • Unfortunately, full body cooling is difficult to do, slow to achieve, and associated with complications2,6
  • Selective brain cooling with theNeuro-Wrap™ avoids the complications seen with full body cooling and can be achieved rapidly and safely
    • Preliminary studies show that brain temperature can be lowered 1.4° C per hour while maintaining normal body temperature
    • Complications of systemic hypothermia do not occur as systemic normothermia is maintained

Links
http://www.cdc.gov/incipc/tib/TBI.htm
http://www6.miami.edu/ummedicine-magazine/winter2005/fstory4.html
http://www.redorbit.com/news/health/1249544/hypothermia_may_help_with_severe_head_injuries/index.html

1Langlois JA, Rutland-Brown W, Thomas, KE. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2004.
2Clifton GL, Miller ER, Choi SC, et al. Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med. 2001 Feb 22;344(8):556-63.
3Clifton GL, Miller ER, Choi SC, Levin HS, McCauley S, Smith KR Jr, Muizelaar JP, Marion DW, Luerssen TG. Hypothermia on admission in patients with severe brain injury. J Neurotrauma. 2002 Mar;19(3):293-301.
4Clifton GL, Allen S, Barrodale P, et al. A phase II study of moderate hypothermia in severe brain injury. J Neurotrauma. 1993 Fall;10(3):263-71.
5Marion DW, Penrod LE, Kelsey SF, Obrist WD, Kochanek PM, Palmer AM, Wisniewski SR, DeKosky ST. Treatment of traumatic brain injury with moderate hypothermia. N Engl J Med. 1997 Feb 20;336(8):540-6.
6Alderson P, Gadkary C, Signorini DF. Therapeutic hypothermia for head injury. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD001048. Review.

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