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Keeping a Cool Head

Neurosurgeons are counteracting brain trauma by lowering the body heat of their patients.

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.