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REVIEW ARTICLE
Year : 2019  |  Volume : 5  |  Issue : 4  |  Page : 187-194

Cold blood perfusion for selective hypothermia in acute ischemic stroke


1 Department of Neurosurgery, Division of Cerebrovascular Surgery, University of Rochester, Rochester, NY, USA
2 Department of Neurosurgery, Otolaryngology and Imaging Sciences, London Health Sciences Centre, Western University, London, ON, Canada

Correspondence Address:
Dr. Thomas K Mattingly
601 Elmwood Ave, Box 670, Rochester, NY 14642
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bc.bc_17_19

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Hypothermia is the most reliably effective neuroprotectant, and yet systemic complications limit application. A large body of animal data suggests that hypothermia is effective for focal cerebral ischemia, namely acute ischemic stroke. In order to apply hypothermia effectively, a selective approach is required to maximize the effect on the brain while minimizing systemic side effects. Due to poor transferability of promising findings in rodent models to human clinical trials for neuroprotection, the focus of this review is large animal gyrencephalic models. Unlike rodent data which favor mild hypothermia, the majority of large animal studies on selective hypothermia support moderate-to-deep hypothermia (<30°C). Cold blood perfusion produces the rapid rate of temperature reduction and depth of hypothermia required to produce meaningful neuroprotection. Further studies of selective hypothermia in acute ischemic stroke require attention to duration and rate of cooling to optimize the neuroprotection offered by this technique.


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