Therapeutic craniocerebral hypothermia in managemenrt of acute ischemic stroke patients.

I.A.Sharinova, O.A.Shevelev, V.I.Shmirev, M.V.Tardov,  I.E.Kalenova, N.I.Litvinov

Objectives

Craniocerebral hypothermia (CCH) is the mild therapeutic hypothermia variant with primary brain cooling.  Specific features of  CCH is the possibility to use this method without  any sedation of patients. We study the impact of therapeutic CCH on neurological status, cerebral blood flow, hemodynamic parameters and body temperature.

Materials and methods

This prospective study conducted in patients admitted to sroke unit between January 2012 and December 2014. Including criteria was acute ischemic stroke first 72 hours. Excluding criteria was bradycardia. We used the therapeutic hypothermia helmet device for CCH induction. The ultrasound Doppler analyzer used for recording  of the cerebral blood flow velocity. Neurological status (NIHSS), hemodynamic parameters, and tympanic temperature were studied before and after CCH.

Results

The total numbers of patients ware 115 stroke patients. 85 patients (mean age 68 +/-12,2 , men 41,women 27) consists therapeutic hypothermia group; control group included 30 similar patients (mean age 68.8+/- 12,3 , men 13,women 17). Neurological deficit degree decreased in CCH group ( 35.2%).  There was not  any significant different in neurological status of control group patients. MCA mean blood flow velocity increased in hypothermia group (61%). Tympanic temperature significantly declined from 37.1+/-0.72°C to 34.6+/-0.8°C. Hemodynamic parameters didn't statistically differ in hypothermia and control group. We calculate decrease of the mortality in CCH patients.

Conclusions

Craniocerebral hypothermia promotes regression of the neurological deficit, increasing of the cerebral blood flow velocity. Hemodynamic parameters remained stable during all craniocerebral hypothermia procedure.