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Benefits of Hypothermia for Young Patients with Acute Subdural Hematoma: A Computed Tomography Analysis of the Brain Hypothermia Study

Title: Benefits of Hypothermia for Young Patients with Acute Subdural Hematoma: A Computed Tomography Analysis of the Brain Hypothermia Study
Authors: Hitoshi Kobata; Yasuhiro Kuroda; Eiichi Suehiro; Tadashi Kaneko; Motoki Fujita; Naofumi Bunya; Kei Miyata; Akihiko Inoue; Toru Hifumi; Yasutaka Oda; Kenji Dohi; Susumu Yamashita; Tsuyoshi Maekawa; Collaboration group
Source: Neurotrauma Reports, Vol 3, Iss 1, Pp 250-260 (2022)
Publisher Information: SAGE Publishing, 2022.
Publication Year: 2022
Collection: LCC:Medical emergencies. Critical care. Intensive care. First aid
Subject Terms: acute subdural hematoma; computed tomography; evacuated hematoma; hypothermia; targeted temperature management; traumatic brain injury; Medical emergencies. Critical care. Intensive care. First aid; RC86-88.9
Description: Therapeutic hypothermia for severe traumatic brain injury (TBI) has been repeatedly studied, but no past studies have assessed the detailed head computed tomography (CT) findings. We sought to investigate individual CT findings of severe TBI patients treated with targeted temperature management utilizing the head CT database obtained from the Brain Hypothermia study. Enrolled patients underwent either mild therapeutic hypothermia (32.0?C?34.0?C) or fever control (35.5?C?37.0?C). We assessed individual head CT images on arrival and after rewarming and investigated the correlations with outcomes. The initial CT data were available for 125 patients (hypothermia group?=?80, fever control group?=?45). Baseline characteristics and CT findings, such as hematoma thickness and midline shift, were similar in all aspects between the two groups. The favorable outcomes in the hypothermia and fever control groups were 38 (47.5%) and 24 (53.3%; p?=?0.53) for all 125 patients, respectively; 21 (46.7%) vs. 10 (38.5%; p?=?0.50) for 71 patients with acute subdural hematoma (SDH), respectively; and 12 (75.0%) vs. 4 (36.4%; p?=?0.045) in 27 young adults (?50 years) with acute SDH, respectively. There was a trend toward favorable outcomes for earlier time to reach 35.5?C (190 vs. 377?min, p?=?0.052) and surgery (155 vs. 180?min, p?=?0.096) in young patients with acute SDH. The second CT image revealed progression of the brain injury. This study demonstrated the potential benefits of early hypothermia in young patients with acute SDH, despite no difference in CT findings between the two groups. However, the small number of cases involved hindered the drawing of definitive conclusions. Future studies are warranted to validate the results.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2689-288X
Relation: https://doaj.org/toc/2689-288X
DOI: 10.1089/NEUR.2021.0080
Access URL: https://doaj.org/article/7f0b752a68ad4e2fbe1bd5d265fcf3cf
Accession Number: edsdoj.7f0b752a68ad4e2fbe1bd5d265fcf3cf
Database: Directory of Open Access Journals