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Wiley InterScience

International Journal of Stroke

International Journal of Stroke

Volume 1 Issue 1, Pages 9 - 19

Published Online: 21 Nov 2005

Journal Compilation © 2010 World Stroke Organization



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Review article
Therapeutic hypothermia for acute stroke
Patrick D. Lyden 1 * , Derk Krieger 2 , Midori Yenari 3,4 and W. Dalton Dietrich 5
  1 Neurology and Research Services of the San Diego Veteran's Administration Medical Center and the Department of Neurosciences, University of California, San Diego, CA, USA
  2 Section of Stroke and Neurological Critical Care, The Cleveland Clinic Foundation, Cleveland, OH, USA
  3 Department of Neurology, University of California San Francisco School of Medicine, San Francisco, CA, USA
  4 Neurology Department of the San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
  5 Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL, USA
 Correspondence: Patrick D. Lyden*, UCSD Stroke Center, OPC 3rd Floor, Suite #3, 200 W. Arbor Drive, San Diego, CA 92103, USA. Tel: 619 543 7760; Fax: 619 543 7771; email: plyden@ucsd.edu
Copyright © 2005 International Stroke Society

ABSTRACT

Abstract Hypothermia is the most potent neuroprotective therapy available. Clinical use of hypothermia is limited by technology and homeostatic mechanisms that maintain core body temperature. Recent advances in intravascular cooling catheters and successful trials of hypothermia for cardiac arrest revivified interest in hypothermia for stroke, resulting in Phase 1 clinical trials and plans for further development. Given the recent spate of neuroprotective therapy failures, we sought to clarify whether clinical trials of therapeutic hypothermia should be mounted in stroke patients. We reviewed the preclinical and early clinical trials of hypothermia for a variety of indications, the putative mechanisms for neuroprotection with hypothermia, and offer several hypotheses that remain to be tested in clinical trials. Therapeutic hypothermia is promising, but further Phase 1 and Phase 2 development efforts are needed to ensure that cooling of stroke patients is safe, before definitive efficacy trials.


DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1747-4949.2005.00011.x About DOI

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