Mild Therapeutic Hypothermia as a targeted Therapy for Severe Traumatic Brain Injury

• Project/Area Number: 18591617
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Cerebral neurosurgery
• Research Institution: Kurume University
• Principal Investigator: SHIGEMORI Minoru Kurume University, 医学部, 教授 (00080804)
• Co-Investigator(Kenkyū-buntansha): TOKUTOMI Takashi 久留米大学, 医学部, 教授 (90197872) ; MIYAGI Tomota 久留米大学, 医学部, 准教授 (40268909) ; SHIOMI Naoto 久留米大学, 医学部, 講師 (70360279)
• Project Period (FY): 2006 – 2008
• Project Status: Completed (Fiscal Year 2008)
• Budget Amount: ¥2,520,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥420,000); Fiscal Year 2008: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2007: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2006: ¥700,000 (Direct Cost: ¥700,000)
• Keywords: 重症頭部外傷 / 低体温療法 / ICP

Research Abstract

Glasgow Coma Scale 8以下の重症頭部外傷例に対して、35℃の微低体温療法を行った。その結果、頭蓋内圧や脳灌流圧などの良好な管理ができ、また6ヶ月後の転帰も約50%で良好な転帰が得られ、死亡率は30%であった。35℃の微低体温療法は重症頭部外傷例に対する標的治療として有効と考えるが、但しGCS 4以下の最重症例では転帰改善には更なる治療法の確立が必要と思われる。

Research Products

• [Journal Article] Effect of 35℃ hypothermia on intracranial pressure and clinical outcome in patients with severe traumatic brain injury. (2009)
  • Author(s): Tokutomi T, Miyagi T, Takeuchi Y, Karukaya T, Katsuki H, Shigemori M
  • Journal Title: Journal of Trauma 66(1) Pages: 166-173
  • Peer Reviewed
• [Journal Article] Effect of hypothermia on intracranial pressure and clinical outcome in patients with severe traumatic brain injury (2009)
  • Author(s): Tokutomi T
  • Journal Title: Journal of Trauma 66 Pages: 166-173
  • Peer Reviewed
• [Journal Article] Optimal temperature for the management of severe traumatic brain injury: Effect of hypothermia on intracranial pressure, systemic and intracranial hemodynamics, and metabolism. (2008)
  • Author(s): Tokutomi T, Morimoto K, Miyagi T, Yamaguchi S, Ishikawa K, Shigemori M
  • Journal Title: Neurosurgery 61(supple 1) Pages: 256-266
  • Peer Reviewed
• [Journal Article] Age-associated increases in poor outcomes after traumatic brain injury: A report from the Japan Neurotrauma Data Bank. (2008)
  • Author(s): Tokutomi T, Miyagi T, Ogawa T, Ono J, Kawamata T, Sakamoto T, Shigemori M, Nakamura N
  • Journal Title: Journal of Neurotrauma 25(12) Pages: 1407-1414
  • Peer Reviewed
• [Journal Article] Optimal temperature for the management of severe traumatic brain injury : Effect of hypothermia on intracranial pressure, systemic and intracranial hemodynamics, and metabolism (2008)
  • Author(s): Tokutomi T
  • Journal Title: Neurosurgery 61 Pages: 256-266
  • Peer Reviewed
• [Journal Article] Age-associated increases in poor outcomes after traumatic brain injury : A report from the Japan Neurotrauma Data Bank (2008)
  • Author(s): Tokutomi T
  • Journal Title: Journal of Neurotrauma 25 Pages: 1407-1414
  • Peer Reviewed
• [Journal Article] Characteristics of cognitive function in patients after traumatic brain injury assessed by visual and auditory event-related potentials. (2007)
  • Author(s): Doi R, Morita K, Shigemori M, Tokutomi T, Maeda H
  • Journal Title: Am. J. Phys. Med. Rehabil. 86(8) Pages: 641-649
  • Peer Reviewed
• [Journal Article] 高齢者急性硬膜下血腫の治療成績と転帰要因 (2007)
  • Author(s): 塩見直人, 宮城知也, 原 真弥, 徳富孝志, 重森 稔
  • Journal Title: Geriatric Neurosurgery 19 Pages: 67-71
  • Peer Reviewed
• [Journal Article] 頭部外傷治療のスタンダードと問題点 重症頭部外傷モニタリングの実際 (2007)
  • Author(s): 徳富孝志
  • Journal Title: 脳神経外科ジャーナル 16(12) Pages: 906-912
  • Peer Reviewed
• [Journal Article] 重症頭部外傷治療・管理のガイドラインに関する調査。現ガイドラインに準拠した治療は頭部外傷患者の予後に影響を与えたか? (2007)
  • Author(s): 徳富孝志, 小川武希, 重森 稔
  • Journal Title: 脳神経外科ジャーナル 16(1) Pages: 13-17
  • Peer Reviewed
• [Journal Article] 重症頭部外傷例に対する初期診療が転帰に与える影響。特に脳神経外科医の役割についてー。 (2007)
  • Author(s): 塩見直人, 宮城知也, 刈茅 崇, 徳富孝志, 重森 稔
  • Journal Title: 脳神経外科 35(3) Pages: 251-257
  • Peer Reviewed
• [Journal Article] Characteristics of cognitice function in patients after traumatic brain in jury assessed by visual and auditory event-rekated potentials (2007)
  • Author(s): Doi R, Morita K, Shigemori M, Tokutomi T, Maeda H
  • Journal Title: Am.J.Phys.Med.Rehabil 86(8) Pages: 641-649
  • Peer Reviewed
• [Journal Article] 高齢者急性硬膜下血腫の治療成績と転帰要因 (2007)
  • Author(s): 塩見 直人、宮城 知也、原 真弥、徳富 孝志、重森 稔
  • Journal Title: Geriatric Neurosurgery 19 Pages: 67-71
  • Peer Reviewed
• [Journal Article] 頭部外傷治療のスタンダードと問題点重症頭部外傷モニタリングの実際 (2007)
  • Author(s): 徳富 孝志
  • Journal Title: 脳神経外科ジャーナル 16(12) Pages: 906-912
  • Peer Reviewed
• [Journal Article] 重症頭部外傷治療・管理のガイドラインに関する調査-現ガイドラインに準拠した治療は頭部外傷患者の予後に影響を与えたか?- (2007)
  • Author(s): 徳富孝志, 小川武希, 重森 稔
  • Journal Title: 脳外誌(Jpn J neurosurg(Tokyo)) 16(1) Pages: 13-17
• [Journal Article] 重症頭部外傷例に対する初期診療が転帰に与える影響-特に脳神経外科医の役割について- (2007)
  • Author(s): 塩見直人, 宮城知也, 刈茅 崇, 徳富孝志, 重森 稔
  • Journal Title: 脳神経外科(Neurological Surgery(Tokyo)) 35(3) Pages: 251-257
• [Journal Article] 重症頭部外傷初期診療におけるドクターヘリの有用性 (2006)
  • Author(s): 塩見直人, 宮城知也, 香月裕志, 前田充秀, 重森 稔, 山下典雄, 坂本照夫
  • Journal Title: 日本救急医学会雑誌 17(6) Pages: 219-226
  • NAID: 10018811047
  • Peer Reviewed
• [Journal Article] 頭部外傷ガイドラインの検証 (2006)
  • Author(s): 小川武希, 徳富孝志
  • Journal Title: 脳神経外科ジャーナル 15(7) Pages: 498-504
  • NAID: 110004740357
  • Peer Reviewed
• [Journal Article] 重症頭部外傷に対する急性期治療の現状:頭部外傷データバンクの分析から (2006)
  • Author(s): 小野純一, 小川武希, 坂本哲也, 川又達朗, 徳富孝志, 片山容一, 重森 稔, 山浦 晶, 中村紀夫
  • Journal Title: Neurosurgical Emergency 11(2) Pages: 133-140
  • Peer Reviewed
• [Journal Article] 実験的頭部外傷後のラット海馬CA1ニューロンにおける過興奮に対する軽度低体温の効果 (2006)
  • Author(s): 大場さとみ, 山下 伸, 蓮尾 博, 徳富孝志, 赤須 崇, 重森 稔
  • Journal Title: 神経外傷 29(1) Pages: 38-43
  • NAID: 10031136352
  • Peer Reviewed
• [Journal Article] Final report of the Japan Neurotrauma Data Bank project 1998-2001: 1002 cases of traumatic brain injury. (2006)
  • Author(s): Nakamura N, Yamaura A, Shigemori M, Ogawa T, Tokutomi T, Ono J, Kawamata T, Sakamoto T
  • Journal Title: Neurologia medico-chirurgica 46 Pages: 567-574
  • NAID: 110005716934
  • Peer Reviewed
• [Journal Article] 重症頭部外傷初期診療におけるドクターヘリの有用性 (2006)
  • Author(s): 塩見直人, 宮城知也, 香月裕志, 前田充秀, 重森 稔, 山下典雄, 坂本照夫
  • Journal Title: 日救急医会誌 17(6) Pages: 219-226
  • NAID: 10018811047
• [Journal Article] 頭部外傷ガイドラインの検証 (2006)
  • Author(s): 小川武希, 徳富孝志
  • Journal Title: 脳外誌(Jpn J neurosurg(Tokyo)) 15(7) Pages: 498-504
  • NAID: 110004740357
• [Journal Article] 重症頭部外傷に対する急性期治療の現状:頭部外傷データバンクの分析から (2006)
  • Author(s): 小野純一, 小川武希, 坂本哲也, 川又達朗, 徳富孝志, 片山容一, 重森 稔, 山浦 晶, 中村紀夫
  • Journal Title: Neurosurg Emerg 11(2) Pages: 133-140
• [Journal Article] Final report of the Japan neurotrauma data band project 1998-2001 : 1002cases of traumatic brain injury (2006)
  • Author(s): 中村紀夫, 山浦 晶, 重森 稔, 小川武希, 徳富孝志, 小野純一, 川又達朗, 坂本哲也
  • Journal Title: Neurol Med Chir(Tokyo) 46(12) Pages: 567-574
• [Presentation] Lesson learned from neurotrauma project (2008)
  • Author(s): Shigemori M
  • Organizer: International Conference of Multidisciplinary Neurotraumatology
  • Place of Presentation: NAGOYA
  • Year and Date: 2008-10-30
• [Presentation] Lesson learned from Neurotrauma Project (2008)
  • Author(s): Shigemori M.
  • Organizer: International Conference of Multidisciplinary Neurotraumatology
  • Place of Presentation: Nagoya
  • Year and Date: 2008-10-30
• [Presentation] Higher brain dysfunction after traumatic brain injury (TBI) (2007)
  • Author(s): Shigemori M, Tokutomi T, Doi R, Morita K, Watanabe R
  • Organizer: 2^<nd> Congress of International Society of Reconstructive Neurosurgery
  • Place of Presentation: 台北
• [Presentation] Higher brain dysfunction after traumaticbrain in jury (TBI) (2007)
  • Author(s): Shigemori M, ToktomiT, Doi R, Morita K, Watanabe R
  • Organizer: 2nd Congress of Internarional Society of Reconstructive Neurosurgery
  • Place of Presentation: 台北
• [Book] 脳神経外科アドバンス (2008)
  • Author(s): 重森 稔, 塩見直人
  • Publisher: 診断と治療社
• [Book] 脳神経外科アドバンス (2008)
  • Author(s): 重森稔
  • Publisher: 診断と治療社
• [Book] 脳神経外科専門医をめざすための経験すべき手術44 (2007)
  • Author(s): 塩見直人, 重森 稔, メジカルビュー
• [Book] 脳神経外科専門医をめざすための経験すべき手術44 (2007)
  • Author(s): 塩見 直人、重森 稔
  • Publisher: メジカルビュー社