Neuroprotective use of mild hypothermia in patients with severe vasospasms after subarachnoid haemorrhage.
BACKGROUND
The authors describe two cases of patients with a severe subarachnoid haemorrhage, where mild hypothermia was successfully applied as a part of comprehensive neuroprotective therapy.


METHODS
A 56-year-old patient was admitted to an intensive care unit with the diagnosis of subarachnoid haemorrhage, with a consciousness dysfunction requiring artificial ventilation. Angiography failed to establish the cause of the haemorrhage, even after repeated examinations. Furthermore, the authors describe the case of a 28-year-old woman with negative anamnesis and without long-term pharmacological medication, who was admitted to the hospital with a severe headache and a qualitative consciousness dysfunction. Angiography showed an aneurysm appearing closely above the left internal carotid artery bifurcation. After detecting vasospasms, mild hypothermia was repeatedly used in both patients, keeping the temperature of the body core between 34-34.5 degrees C.


RESULTS
The total length of the introduced therapeutic hypothermia was 12 days in the first case and 6 days in the second case. The method used was non-invasive all-body cooling by means of blankets with circulating cooling liquid (Blanketrol II, Cinncinnati Sub Zero). In both cases the computed tomography findings and the clinical conditions gradually improved and the patients were released from the intensive care unit on the 22nd and 30th day, respectively, following the disorder detection.


CONCLUSIONS
Mild hypothermia is a clinically attainable neuroprotective method, which--in combination with other therapeutic measures--led to minimising the neurological deficit in patients with severe subarachnoid haemorrhage (Ref. 11).
Strazevska
E
E
Department of Anaesthesiology and Intensive Care, Medical Faculty ofMasaryk University Brno, University Hospital Brno, Czech Republic. estrazevska@fnbrno.cz
Stasek
J
J
Sevcik
P
P
D000328:Adult; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D020301:Vasospasm, Intracranial / Q000209:etiology / Q000628:therapy*