PDF(Pubmed)
Abstract：
In ischemic stroke, selectively cooling the ischemic penumbra might lead to neuroprotection while avoiding systemic complications. Because penumbral tissue has reduced cerebral blood flow and in vivo brain temperature measurement remains challenging, the effect of different methods of therapeutic hypothermia on penumbral temperature are unknown. We used the COMSOL Multiphysics® software to model a range of cases of therapeutic hypothermia in ischemic stroke. Four ischemic stroke models were developed with ischemic core and/or penumbra volumes between 33-300 mL. Four experiments were performed on each model, including no cooling, and intraarterial, intravenous, and active conductive head cooling. The steady-state temperature of the non-ischemic brain, ischemic penumbra, and ischemic core without cooling was 37.3 °C, 37.5-37.8 °C, and 38.9-39.4 °C respectively. Intraarterial, intravenous and active conductive head cooling reduced non-ischemic brain temperature by 4.3 °C, 2.1 °C, and 0.7-0.8 °C respectively. Intraarterial, intravenous and head cooling reduced the temperature of the ischemic penumbra by 3.9-4.3 °C, 1.9-2.1 °C, and 1.2-3.4 °C respectively. Active conductive head cooling was the only method to selectively reduce penumbral temperature. Clinical studies that measure brain temperature in ischemic stroke patients undergoing therapeutic hypothermia are required to validate these hypothesis-generating findings.
摘要：
在缺血性中风中，选择性冷却缺血半暗带可能导致神经保护，同时避免全身并发症。由于半影组织减少了脑血流量，体内脑温度测量仍然具有挑战性，不同的低温治疗方法对半影温度的影响尚不清楚。我们使用COMSOLMultiphysics®软件对缺血性卒中治疗性低温的一系列病例进行建模。开发了四种缺血性卒中模型，其缺血性核心和/或半影体积在33-300mL之间。对每个模型进行了四个实验，包括无冷却，动脉内，静脉注射,和主动导电头冷却。非缺血大脑的稳态温度，缺血半暗带，无冷却的缺血核心为37.3°C，37.5-37.8°C,和38.9-39.4°C。动脉内,静脉内和主动传导头冷却可将非缺血性脑温度降低4.3°C，2.1°C,和0.7-0.8°C分别。动脉内,静脉内和头部冷却可使缺血半影的温度降低3.9-4.3°C，1.9-2.1°C,和1.2-3.4°C。主动传导头冷却是选择性降低半影温度的唯一方法。需要进行临床研究来测量接受低温治疗的缺血性中风患者的脑温度，以验证这些假设产生的发现。
