Use of Prolonged Hypothermia to Treat Ischemic and Hemorrhagic Stroke (Report‪)‬

Introduction NO OTHER CYTOPROTECTIVE (neuroprotective) treatment has been so extensively studied as therapeutic hypothermia (TH). Indeed, there are hundreds of animal studies, dozens of clinical trials, numerous comprehensive reviews (Colbourne et al., 1997; Dietrich et al., 1996; Zhao et al., 2007), and a recent meta-analysis (van der Worp et al., 2007). Our purpose here is not to completely review this literature, but to focus on a few issues of central importance to treatment success, such as the duration of TH. We further limit the scope of this review to ischemic and hemorrhagic brain injury in adults, and mostly to work done in animal stroke and cardiac arrest models. The goals of these pre-clinical studies of TH, which have mostly been done in rodents, are to (1) determine whether TH improves outcome for each insult type, (2) clarify the conditions under which protection is found (e.g., intervention delay), (3) optimize treatment parameters, (4) identify possible side effects (e.g., re-warming complications), and (5) determine how TH works so that it may be augmented or replaced with safer and easier-to-administer treatments. This review deals largely with goals 1-3.