title: Successful use of prolonged mild hypothermia in a patient with severe head injury and diffuse brain swelling. Case report.
abstract: A 19-year-old female was admitted to our hospital after severe head injury in a traffic accident. On admission, she had no spontaneous respiration, but did have heart beat with a blood pressure of 100/60 mmHg. Neurological examination demonstrated that the Glasgow Coma Scale score was 3 and her pupils were fixed and dilated. Computed tomography (CT) showed diffuse brain swelling with disappearance of the perimesencephalic cistern. Chest CT showed bilateral lung contusions. Mild hypothermia with a target temperature of 33 degrees C was immediately induced, and was continued for 28 days to control the persistent increase in intracranial pressure (ICP). Subsequently, she recovered, and 20 months after admission, could speak and walk with slight hemiparesis on the left. Prolonged mild hypothermia may be effective to control persistent increase in ICP due to diffuse brain swelling.
authors: Department of Neurosurgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. mmurakam@tokyo-med.ac.jp
authors: Mamoru
authors: M
authors: Murakami
authors: Tetsuya
authors: T
authors: Tsukahara
authors: Hiroyasu
authors: H
authors: Ishikura
authors: Taketo
authors: T
authors: Hatano
authors: Takuya
authors: T
authors: Nakakuki
authors: Eiji
authors: E
authors: Ogino
authors: Takako
authors: T
authors: Aoyama
mesh_terms: D000328:Adult; D001929:Brain Edema / Q000209:etiology / Q000628:therapy*; D001930:Brain Injuries / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*