Keeping a Cool Head

Sprain a knee and your doctor will tell you to ice the injury to
prevent swelling. Now neurosurgeons are applying the same principle to
people with severe head injuries.

By lowering patients' body temperature to a relatively chilly 88
degrees Fahrenheit, researchers at the University of Pittsburgh Medical
Center (UPMC) are counteracting one of most troublesome side effects of
brain trauma. The body's inflammatory response often produces swelling in
newly injured tissues, whether in the ankle or cerebrum. But since the
skull's rigidity doesn't let a swelling brain expand, pressure can build
inside the head after an injury. "If the pressure gets high enough, it
cuts off the blood supply to the brain," notes UPMC neurosurgeon Donald
Marion, M.D. Such "secondary injuries" are responsible for up to half of
the neurological problems that plague brain-injured people after an
accident.

In a study reported in the New England Journal of Medicine,
Marion's team was able to boost the odds of recovery by chilling the
brain (and the rest of the body) for 24 hours after the trauma. Among
brain-injured patients who were unconscious but not comatose upon
arriving at the E.R., 55 percent were back at work six months later if
their brains had been cooled after their injury. Only 12 percent of those
who didn't receive the treatment were able to return to work or school in
that time.