A clinical study on hypothermia treatment for severe diffuse axonal injury

Objective To analyze the effect and mechanism of hypothermia (HT) treatment for severe diffuse axonal injury. Methods sixty five cases were treated with moderate HT group and thirty three cases with normal temperature (control group). Intracranial pressure (ICP), cranial perfusion pressure (CPP), brain electrical activity map (BEAM), endothelin (ET), transcranial ultrasonic Doppler (TCD) findings and prognosis (GOS) were observed both before and after moderate hypothermia treatment. Results In the treatment group, ICP, CCP, BEAM and outcome were improved after HT treatment with a significant difference compared with the control group. After hypothermia treatment, the average level of ET in the treatment group was reduced from (92.31±11.58) ng/L to (55.83±3.83) ng/L ( P 0.01). While in the control group. Records of MCA mean velocity (Vm) were reduced from (65.1±4.9) cm/s to (52.7± 4.3) cm/s ( P 0.01). A decrease was seen in MCA systolic velocity (Vs) and pulse index(PI) value with a significant difference ( P 0.01 ). Conclusions HT treatment can decrease ICP, increase CCP and improve the clinical manifestation, BEAM and outcome of severe diffuse axonal injury patients by means of decreasing acute stage ET, improving the blood velocity of MCA and decreasing cerebral vascular resistance. HT treatment can reduce cerebral vascular spasms, cerebral ischemia and hypoxia.