Related Experiment Video
Updated: Jun 21, 2026
05:00
Short-Duration Hypothermia Induction in Rats using Models for Studies examining Clinical Relevance and Mechanisms
Published on: March 3, 2021
Regional cooling for reducing brain temperature and intracranial pressure
Luis Vicente Forte1, Cássio Morano Peluso, Mirto Nelso Prandini
1Intensive and Critical Medicine, Neurosurgical Intensive Care Unit, Hospital Meridional, Real e Benemérita Sociedade Portuguesa de Beneficência de São Paulo, São Paulo, SP, Brazil. fortelv@uol.com.br
Arquivos De Neuro-Psiquiatria
|July 23, 2009
Summary
Regional cooling effectively lowered brain temperature and intracranial pressure in patients with failed conventional treatments. This method shows promise for managing refractory intracranial pressure after decompressive craniectomy.
Area of Science:
- Neurosurgery
- Critical Care Medicine
- Therapeutic Hypothermia
Background:
- Elevated intracranial pressure (ICP) is a life-threatening condition often refractory to standard treatments.
- Decompressive craniectomy is a surgical intervention to reduce ICP, but further management may be required.
- Regional cooling presents a potential therapeutic strategy for managing refractory ICP.
Purpose of the Study:
- To assess the efficacy of regional cooling in reducing brain temperature (BrTe) and ICP.
- To evaluate regional cooling as a treatment for patients with failed conventional therapies for elevated ICP.
- To investigate the impact of mild brain hypothermia induced by regional cooling on ICP control.
Main Methods:
- Regional cooling was applied using ice bags to the craniectomy site in 23 patients.
- Brain temperature (BrTe) and intracranial pressure (ICP) were monitored using fiber optic sensors.
- Patients received a mean of 61.7 hours of regional cooling.
Main Results:
- A statistically significant reduction in mean BrTe from 37.1°C to 35.2°C (p<0.0001) was observed.
- Mean ICP significantly decreased from 28 mmHg to 13 mmHg (p=0.0001).
- The intervention was applied to patients with a mean APACHE II score of 25.
Conclusions:
- Mild brain hypothermia induced by regional cooling is effective in controlling ICP.
- Regional cooling demonstrates efficacy in patients who have undergone decompressive craniectomy.
- This method offers a viable option for managing refractory intracranial pressure.
Related Concept Videos
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
01:29Decreased Body Temperature
A decreased body temperature can occur in patients with hypothermia and frostbite. Heat loss with extended cold exposure overpowers the body's ability to create heat, resulting in hypothermia. Core temperature readings help classify hypothermia. Mild hypothermia is temperatures between 32 °C (89.6 °F) and 35°C (95 °F) and is caused by impaired thermoregulation. Moderate hypothermia is temperatures between 28 C (82.4 °F) and 32 °C (89.6 °F) caused by sustained extreme cold exposure, and severe...
01:22Methods of reducing fever
The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
Pharmacological Methods of Reducing Fever:
Pharmacological Methods of Reducing Fever:
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:19Cerebral Edema l: Introduction
Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...