The state of neuronal damage after severe brain injury may progress with time. Similary, the target of management may also differ within the injury time window in severely brain-injured patients. In addressing this clinical issue, early management is much easier and simpler than delayed induction of hypothermia treatment. Accordingly, the main targets of treatment at early and late stages need to be defined. In some cases, control of brain edema and intracranial pressure (ICP) elevation have been the focus of initial treatment for neuroprotection in severely brain-injured patients [2,11,14]. However, this approach is not correct because brain edema and ICP elevation occur as a result of neuronal hypoxia, adequate metabolic supply to the injured neurons, cerebral blood flow (CBF) disturbances, unsuccessful management of cardiopulmonary dysfunction, and hemoglobin dysfunction . For brain hypothermia management of severe brain injury, the starting time is important and the main target of management will change according to the time after insults and trauma [3,4].
KeywordsBrain Edema Severe Brain Injury Early Induction Injured Neuron Critical Head Injury
Unable to display preview. Download preview PDF.
- 1.Baker AJ, Zornow MH, Scheller MS, Yaksh TL, Skilling SR, Smullin DH, Larson AA, Kuczenski R (1991) Changes in extrascellular concentrations of glutamate, aspartate, glycine, dopamine, serotonin, and dopamine metabolites after transient global ischemia in the rat. J Neurochemistry 57:1370–1379CrossRefGoogle Scholar
- 3.Hayashi N (1995) Cerebral hypothermia treatment. In: Hayashi N (ed) Cerebral hypothermia treatment. Sogo Igaku, Tokyo, pp 1–105Google Scholar
- 6.Hayashi N, Hirayama T, Utagawa A (1994) The cerebral thermo-pooling and hypothermia treatment of critical head injury patients. In: Nagai H (ed) Intracranial pres sure IX. Springer, Berlin Heidelberg New York Tokyo, pp 589–599Google Scholar
- 11.Macintosh TK (1994) Neurological sequele of traumatic brain injury: therapeutic implications. Cerebrovasc Brain Metab Rev 6:109–162Google Scholar
- 13.Silvka A, Coben G (1985) Hydroxyl radical attack on dopamine. J Biol Chem 260:15466–15472Google Scholar