Brain Hypothermia for Occlusive Cerebral Stroke

  • Nariyuki Hayashi
  • Dalton W. Dietrich


The mechanism of brain damage caused by occlusive cerebral stroke is different with acute onset and chronic progression. The harmful stress-associated neurohormonal reactions of the hypothalamus—pituitary—adrenal (HPA) axis and hyperglycemia [8, 9, 10] are only observed at the acute onset of large cerebral infarction (Table 82.) In this group, a higher incidence of complete cerebrovascular obstruction (CVO) than incomplete CVO was recorded. However, in cases of slow onset, incomplete occlusive cerebral stroke or small cerebral infarction are most common and stress-associated hyperglycemia is not recorded. The intensive care unit (ICU) management strategy is different in these two groups.


Cerebral Infarction Slow Onset Brain Stem Infarction Selective Brain Cool Brain Hypothermia 
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  1. 1.
    Almeida A, Delgado-Esteban M, Bolanos JP, Medina JM (2002) Oxygen and glucose deprivation induces mitochondrial dysfunction and oxidative stress in neurones but not in astrocytes in primary culture. J Neurochem 81: 207–217PubMedCrossRefGoogle Scholar
  2. 2.
    Benveniste H, Jorgensen MB, Sandberg M, Christensen T, Hagberg H, Diemer NH (1989) Ischemic damage in hippocampal CA1 is dependent on glutamate release and intact innervation from CA3. J Cereb Blood Flow Metab 9:629–639PubMedCrossRefGoogle Scholar
  3. 3.
    Busto R, Dietrich WD, Globus MY-T, Ginsberg MD (1989) Postischemic moderate hypothermia inhibits CA1 hippocampal ischemic neuronal injury. Neurosci Lett 101:299–304PubMedCrossRefGoogle Scholar
  4. 4.
    Connolly JE, Boyd RJ, Calvin JW (1962) The protective effect of hypothermia in cerebral ischemia: experimental and clinical applications by selective brain cooling in the human. Surgery 52:15–24PubMedGoogle Scholar
  5. 5.
    Dietrich WD, Busto R, Halley M, Valdes I (1990) The importance of brain temperature in alterations of the blood-brain barrier following cerebral ischemia. J Neuropathol Exp Neurol 49:486–497PubMedCrossRefGoogle Scholar
  6. 6.
    Dorman PJ, Counsell CE, Sanderrock PGA (2000) Recently developed neuroprotective therapies for acute stroke: a qualitative systematic review of clinical trials. In: Prakash A (ed) Acute stroke treatment. Adis, Hong Kong, pp 63–83Google Scholar
  7. 7.
    Han HS, Qiao Y, Karabiyikoglu M, Giffard RG, Yenari MA (2002) Influence of mild hypothermia on inducible nitric oxide synthase expression and reactive nitrogen production in experimental stroke and inflammation. J Neurosci 22:3921–3928PubMedGoogle Scholar
  8. 8.
    Hayashi N (1997) Prevention of vegetation after severe head trauma and stroke by combination therapy of cerebral hypothermia and activation of immune-dopaminergic nervous system. Proc Soc Treat Coma 6:133–145Google Scholar
  9. 9.
    Hayashi N (2000) Enhanced neuronal damage in severely brain injured patients by hypothalamus, pituitary, and adrenal axis neuro-hormonal changes. In: Hayashi N (ed) Brain hypothermia. Springer, Berlin Heidelberg New York Tokyo, pp 3–26CrossRefGoogle Scholar
  10. 10.
    Hayashi N (2000) The clinical issue and effectiveness of brain hypothermia treatment for severe brain injured patients. In: Hayashi N (ed) Brain hypothermia. Springer, Berlin Heidelberg New York Tokyo, pp 121–151CrossRefGoogle Scholar
  11. 11.
    Lindley RI (2000) Drug therapy for acute ischemic stroke: risks verusus benefits. In: Prakash A (ed) Acute stroke treatment. Adis, Hong Kong, pp 53–62Google Scholar

Copyright information

© Springer Japan 2004

Authors and Affiliations

  • Nariyuki Hayashi
    • 1
    • 2
  • Dalton W. Dietrich
    • 3
    • 4
  1. 1.Nihon University Emergency Medical CenterTokyoJapan
  2. 2.Department of Emergency and Critical Care MedicineNihon University School of MedicineTokyoJapan
  3. 3.Department of Neurological Surgery, Neurology and Cell Biology and AnatomyUniversity of Miami School of MedicineMiamiUSA
  4. 4.The Miami Project to Cure ParalysisMiamiUSA

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