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Current technology for brain cooling unlikely to help trauma patients

Attempts to cool the brain to reduce injury from stroke and other head trauma may face a significant obstacle: current cooling devices can't penetrate very deeply into the brain.

Scientists at Washington University School of Medicine in St. Louis used rats to validate a "cold shielding" effect of blood flow that they previously predicted theoretically. The shielding effect, created by large quantities of warm blood that continually perfuse brain tissue, prevents a drop in temperatures around the head from penetrating beyond a certain depth in the brain.

Many ongoing clinical trials try to reduce brain temperatures through cooling units incorporated into hats or other devices that surround the head. However, the new findings, published online this month in the Journal of Applied Physiology, suggest in most patients such techniques will be unable to defeat the natural temperature regulation built into the brain via the blood system.

"In adult humans, the characteristic length that this kind of cold assault appears to penetrate is approximately a tenth of an inch, leaving the temperature of approximately 6 inches of brain tissue unchanged," says senior author Dmitriy Yablonskiy, Ph.D., professor of radiology at the School of Medicine and of physics in Arts and Sciences. "Our findings suggest that the reason trials of this kind have so far produced inconsistent results is because we're not cooling enough of the brain."

The amount of blood flowing through brain tissue determines the extent of the shielding effect. Young children, infants and in particular newborns have smaller brains with lower blood flow and may be more susceptible to a cooling unit around the head. But for other patients, Yablonskiy asserts, a different approach is needed.

Cold slows down the rate of chemical reactions, potentially slowing the reactions that cause permanent injury in patients with stroke and other head trauma. Attempts to create this
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Contact: Michael Purdy
purdym@wustl.edu
314-286-0122
Washington University School of Medicine
4-Aug-2006


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