Cooling the Body May Minimize Long-Term Effects of Brain Injuries
Posted by
Randy WaltonSeptember 25, 2007 1:59 PMEvery 15 seconds, someone in the U.S. suffers a traumatic brain injury, said Brent Ibata, research coordinator for the division of neurosurgery at SLU. Brain injuries are responsible for 50,000 deaths and 80,000 disabilities each year. Doctors at St. Louis University are performing a study to determine if cooling down the body is the best way to minimize the long-term effects of serious brain injuries. The St. Louis Dispatch reported that the study will measure the effects of inducing mild hypothermia in people who have just suffered traumatic head injuries -- like those caused by car accidents falls or getting hit by heavy objects.
Doctors at St. Louis University are performing a study to determine if cooling down the body is the best way to minimize the long-term effects of serious brain injuries. The St. Louis Dispatch reported that the study will measure the effects of inducing mild hypothermia in people who have just suffered traumatic head injuries -- like those caused by car accidents, falls or getting hit by heavy objects.
This "cool down" approach recently gained national attention when it was used to treat NFL football player Kevin Everett, who suffered a life-threatening spinal cord injury during a game Sept. 9. The cold treatment is credited with preserving Everett's mobility by keeping his spinal cord from swelling and damaging the nerves.
Every 15 seconds, someone in the U.S. suffers a traumatic brain injury, said Brent Ibata, research coordinator for the division of neurosurgery at SLU. Brain injuries are responsible for 50,000 deaths and 80,000 disabilities each year.
The "golden hour" for treating brain trauma passes quickly, usually in less than four hours, but few studies have been done to determine what treatments work best.One evening in 1996, John Thomure and a friend were driving to a convenience store near Washington, Mo. A drunk driver collided with Thomure's car, leaving him with a severe head injury, a ruptured spleen and other injuries. At midnight, Thomure's mother, Lynne Unnerstall, got a phone call from the SLU hospital requesting permission to try cold therapy on her son, one of 390 people nationwide at the time to participate in a preliminary study on hypothermia and brain injuries.
By the time doctors were able to cool Thomure down, nearly six hours had passed since the accident. The window of opportunity to protect his brain was already closed.
Today, Thomure is still unable to walk, has trouble speaking and struggles with memory and impulse control. Unnerstall, now the president of a support group called the Brain Injury Association, is convinced that had her son been cooled quicker, much of the damage to his brain could have been averted. But no one knows for sure.
Hypothermia works by reducing the body's need for oxygen and energy, and holding down inflammation. That's especially important for the nervous system. Brain swelling in the first few days after injury is responsible for most of the permanent damage from head trauma.
Doctors at SLU will lower body temperature of head trauma patients to 91.4 degrees Fahrenheit, using a combination of cold saline in IVs, washing the stomach with ice water, and a cooling device that wraps around the torso and thighs.
"Inducing hypothermia is not going to prevent death, but it could prevent disabilities," Ibata said.
Researchers look to cases like Carrie Green of Centralia, Ill., as evidence of the therapy's potential. In 1996, Green was 16 years old when she ran a stop sign on a rural road near Centralia and was broadsided by another car. Her neck was broken. Her head bashed against the window. She was one step away from brain death. She was airlifted to St. Louis University, where doctors lowered her body temperature to 90 degrees as part of the preliminary study. For three days, Green remained hypothermic, while doctors and her family watched the machines that measured the pressure in her head. "It's just common sense," Green said. "You sprain an ankle and you put ice on it to keep it from swelling. They put me on ice and kept my brain from swelling."
Green is now married with a 3-year-old son, and she is only beset with a few minor coordination problems. "I'm not supposed to water-ski," Green said.
Her mother, Linda Pflasterer, noted that her daughter "still can't really skip" either -- minor limitations for what the family says is a miraculous recovery.
For more information on this subject, please refer to the section on Traumatic Head and Brain Injury.