Hypothermia for acute ischaemic stroke

• Published in: Lancet neurology Vol. 12; no. 3; pp. 275 - 284
• Main Authors: Wu, Tzu-Ching, Dr, Grotta, James C, Prof
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-03-2013; Elsevier Limited
• Subjects: Animals; Apoptosis; Brain Ischemia - drug therapy; Brain Ischemia - therapy; Cardiac arrest; Clinical trials; Coma; Combined Modality Therapy - adverse effects; Combined Modality Therapy - instrumentation; Combined Modality Therapy - methods; Cooling; Cytochrome; Cytokines; Edema; Fibrinolytic Agents - therapeutic use; Free radicals; Heart; Humans; Hypothermia; Intravenous administration; Ischemia; Kinases; Metabolism; Neurology; Reperfusion; Stroke; Stroke - drug therapy; Stroke - therapy; Tissue Plasminogen Activator - therapeutic use; Traumatic brain injury; Tumor necrosis factor-TNF; United States > US
• ISSN: 1474-4422; 1474-4465
• DOI: 10.1016/S1474-4422(13)70013-9

Summary Ischaemic stroke is one of the leading causes of death and disability worldwide, and intravenous alteplase is the only proven effective treatment in the acute setting. Hypothermia has been shown to improve neurological outcomes after global ischaemia–hypoxia in comatose patients who have had cardiac arrest, and is one of the most extensively studied and powerful therapeutic strategies in acute ischaemic stroke. The protective mechanisms of therapeutic hypothermia affect the ischaemic cascade across several parallel pathways and, when coupled with reperfusion strategies, might yield synergistic benefits for patients who have had a stroke. Technological advances have allowed hypothermia to be induced rapidly, and the treatment has been used safely in acute stroke patients. Conclusive efficacy trials assessing therapeutic hypothermia combined with reperfusion therapies in acute ischaemic stroke are ongoing.