{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:58:37Z","timestamp":1787497117817,"version":"build-2736575974"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,8]]},"abstract":"<jats:p content-type=\"fine-print\">\n                    <jats:italic>Object.<\/jats:italic>\n                    This study was performed to determine whether mild hypothermia therapy is essential for the treatment of severely head injured patients in whom intracranial pressure (ICP) can be maintained below 20 mm Hg by using conventional therapies.\n                  <\/jats:p>\n                  <jats:p content-type=\"fine-print\">\n                    <jats:italic>Methods.<\/jats:italic>\n                    Sixteen consecutive severely head injured patients fulfilled the following criteria: the patient's ICP was maintained below 20 mm Hg by using fluid restriction, hyperventilation, and high-dose barbiturate therapy; and the patient had a Glasgow Coma Scale score of 8 or less on admission. After conventional therapies had been applied, the patients were divided randomly into two groups: the mild hypothermia group (HT group; eight patients) and the normothermia group (NT group; eight patients). The HT group received mild hypothermia (intracranial temperature 34\u00b0C) therapy for 48 hours followed by rewarming at 1\u00b0C per day for 3 days, whereas the NT group received normothermia (intracranial temperature 37\u00b0C) therapy for 5 days. Specimens of cerebrospinal fluid (CSF) taken from an intraventricular catheter every 24 hours were analyzed for the presence of excitatory amino acids ([EAAs] glutamate, aspartate, and glycine) and cytokines (tumor necrosis factor\u2014\u03b1, interleukin [IL]-1\u03b2, IL-6, IL-8, and IL-10). The two groups did not differ significantly in patient age, neurological status, or level of ICP. There were no significant differences in daily changes in CSF concentrations of EAAs and cytokines between the two groups. The incidence of pneumonia was slightly higher in the HT group compared with the NT group (p = 0.059). The incidence of diabetes insipidus associated with hypernatremia was significantly higher in the HT group compared with that in the NT group (p &lt; 0.01). The two groups did not differ with respect to their clinical outcomes.\n                  <\/jats:p>\n                  <jats:p content-type=\"fine-print\">\n                    <jats:italic>Conclusions.<\/jats:italic>\n                    The authors recommend normothermia therapy for the treatment of severely head injured patients in whom ICP can be maintained at lower than 20 mm Hg by using conventional therapies, because mild hypothermia therapy does not convey any advantage over normothermia therapy in such patients.\n                  <\/jats:p>","DOI":"10.3171\/jns.1999.91.2.0185","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T13:20:59Z","timestamp":1242220859000},"page":"185-191","source":"Crossref","is-referenced-by-count":89,"title":["Little benefit from mild hypothermia therapy for severely head injured patients with low intracranial pressure"],"prefix":"10.3171","volume":"91","author":[{"given":"Tadahiko","family":"Shiozaki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amami","family":"Kato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamoru","family":"Taneda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Hayakata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Hashiguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Shimazu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"Sugimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"369","DOI":"10.3171\/jns.1993.79.3.0369","article-title":"Excitatory amino acids in cerebrospinal fluid following traumatic brain injury in humans.","volume":"79","author":"Baker","year":"1993"},{"key":"b2","series-title":"J Neurotrauma","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1089\/neu.1997.14.451","article-title":"Interleukin-6 and interleukin-10 in cerebrospinal fluid after severe traumatic brain injury in children.","volume":"14","author":"Bell","year":"1997"},{"key":"b3","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"507","DOI":"10.3171\/jns.1998.89.4.0507","article-title":"Factors affecting excitatory amino acid release following severe human head injury.","volume":"89","author":"Bullock","year":"1998"},{"key":"b4","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1161\/01.STR.20.7.904","article-title":"Effect of mild hypothermia on ischemia-induced release of neurotransmitters and free fatty acids in rat brain.","volume":"20","author":"Busto","year":"1989"},{"key":"b5","series-title":"J Neurotrauma","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1089\/neu.1993.10.263","article-title":"A phase II study of moderate hypothermia in severe brain injury.","volume":"10","author":"Clifton","year":"1993"},{"key":"b6","series-title":"J Neuropathol Exp Neurol","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1097\/00005072-199009000-00004","article-title":"The importance of brain temperature in alterations of the blood-brain barrier following cerebral ischemia.","volume":"49","author":"Dietrich","year":"1990"},{"key":"b7","series-title":"Science","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1126\/science.2567056","article-title":"The role of excitatory amino acids and NMDA receptors in traumatic brain injury.","volume":"244","author":"Faden","year":"1989"},{"key":"b8","series-title":"Lancet","first-page":"480","article-title":"Assessment of outcome after severe brain damage. 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