Therapeutic hypothermia: Treating head injuries with brain freeze

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Yesterday at Wired’s Danger Room, I covered a new military medical initiative that hopes to improve and speed up treatment of traumatic brain injuries among troops. Now, there’s news that athletes might benefit from the same science, which Pentagon program managers are calling “therapeutic hypothermia”.

The military is only in early stages of exploring the possibility that cooling down brain tissue could reduce long-term damage. DARPA, the Pentagon’s advanced research project agency, wants proposals for a portable brain-cooling unit, that could be deployed in the field to target trauma as soon as it occurs. The agency has been on overdrive investigating the underlying cause of TBIs for years, but have had little success in curbing them: it’s been estimated that 70,000 troops returning from Iraq and Afghanistan suffer the consequences of traumatic brain injury, which include depression, anxiety, memory problems and impaired motor skills. Research seems to show that TBIs are caused by repeated exposures to blasts, specifically the “supersonic wave” of highly pressurized air they emit. It only takes a fraction of a second for brain cells to be deformed. The effects then snowball, disturbing a myriad of brain processes.

In Iraq and Afghanistan, road-side bombs are the most common cause of TBIs. In sports, it’s the direct physical contact. But while researchers are scrambling to figure out whether even recreational high school athletes are at risk, a new study brings good news this week. The report, released by researchers at the Barrow Neurological Institute, showed the potential for treating athletic concussions using cortical hypothermia: a specific brain zone is cooled using a process akin to renal dialysis, using a catheter in the carotid artery. A DARPA-friendly system would probably need to be smaller and more efficient, but the Barrow study shows that the brain can be protected, and damage mitigated, using the temperature therapy.

Then there’s the time frame: within 90 seconds of impact, secondary brain cell changes start to occur and can be difficult to reverse. The faster a brain can be chilled, the better: another reason for a quick, portable brain-cooling unit. The incredibly short “golden hour” for treatment means that the thousands of vets, and NFL players, won’t benefit from the idea. But civilians might: according to DARPA, we’re about as likely to suffer a TBI as heart disease. Who knew?