Computer-Aided Analysis of Transient and Steady State Temperature Distribution in Human Brain During Selective Cooling of Head Surface and Rewarming for Head Injury Patients

In recent years, mild or moderate hypothermia during which brain temperature is reduced to 30–35°C has been proposed for clinical use as an adjunct for achieving protection from cerebral ischemia and traumatic brain injury. There are two approaches for achieving a reduction in brain temperature. One is via systemic hypothermia where the whole body is cooled. This approach may produce deleterious systemic complications and require intensive monitoring. Another approach is called selective brain cooling (SBC) in which the brain is selectively cooled while the rest of the body is kept at normal temperature. Clinically feasible SBC protocols include head hood or helmet with water or chemical cooling, head immersion in iced water, nasophyaryngeal cooling after tracheal intubation, and intro-carotid flushing. Simply packing ice or wearing cooling helmet is easy to implement. Previous theoretical study [Zhu and Diao, 2001] suggests that it is feasible to achieve mild hypothermia via head surface cooling. However, most physicians believe that it takes a much longer time to reduce the brain temperature using head surface cooling. In this study, a three-dimensional theoretical model is developed to study the transient and steady state temperature distribution in the brain during SBC. The effect of regionally varying local blood perfusion rate in the brain tissue on the temporal and spatial temperature gradient is examined. Other factors including the brain size and the thermal contact resistance between the cooling medium and the head scalp are evaluated in the simulation.