Severe Brain Trauma

  • Nariyuki Hayashi
  • Dalton W. Dietrich


Marion et al. [16] and Clifton et al. [4] reported the effectiveness of hypothermia, 32°C for 48 h, for severe brain injury in 1993. The hypothermia treatment was focused on neuroprotection, such as prevention of brain edema, prevention of free radical reactions, tolerance of brain hypoxia caused by reduced oxygen consumption, and prevention of intracranial pressure (ICP) elevation [1, 2, 3,6,7,17, 18, 19]. However, in 2001, negative effects of hypothermia treatment (32°C for 48 h) were reported from a multi-trial study by Clifton et al. [5]. This is because the concept of restoration therapy for dying neurons in injured brain tissue, that includes management of hypothalamuspituitary- adrenal (HPA) axis-associated hemoglobin dysfunction [9] and neuronal hypoxia [8,10,11], control of increasing brain tissue lactate with metabolic shift from glucose to lipid [11], control of brain thermopooling [12, 13, 14], management of catecholamine surge-associated insulin-resistant hyperglycemia, consideration of short-duration hypothermia worsening at the rewarming stage [11], management of growth hormone-reduced immune dysfunction [11], selective radical attack to the dopamine A10 nervous system [10], and complication of cytokine encephalitis with pulmonary infections [15], was not included.


Therapeutic Hypothermia Glasgow Coma Scale Score Severe Brain Injury Brain Injured Patient Mild Therapeutic Hypothermia 
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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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