Submitted on May 18, 2007
Accepted on August 24, 2007
Integration of Jugular Venous Return and Circle of Willis in a Theoretical Human Model of Selective Brain Cooling
Matthew Aaron Neimark1*, Angelos-Aristeidis Konstas2, Andrew Francis Laine3, and John Pile-Spellman4
1 Biomedical Engineering, Columbia University, New York, New York, United States
2 Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, United States; Department of Radiology, Columbia University, New York, New York, United States
3 Biomedical Engineering, Columbia University, New York, New York, United States; Department of Radiology, Columbia University, New York, New York, United States
4 Department of Radiology, Columbia University, New York, New York, United States
* To whom correspondence should be addressed. E-mail: man2003{at}columbia.edu.
A three-dimensional mathematical model was developed to examine the induction of selective brain cooling (SBC) in the human brain by intracarotid cold (2.8 °C) saline infusion (ICSI) at 30 ml/min. The Pennes bioheat equation was used to propagate brain temperature. The effect of cooled jugular venous return was investigated, along with the effect of the Circle of Willis (CoW), on the intracerebral temperature distribution. The complete complete CoW, missing A1 variant (mA1), and fetal P1 variant (fP1) were simulated. ICSI induced moderate hypothermia (defined as 32-34 °C) in the internal carotid artery (ICA) territory within 5 minutes. Incorporation of the complete CoW resulted in a similar level of hypothermia in the ICA territory. In addition, the anterior communicating artery and ipsilateral posterior communicating artery distributed cool blood to the contralateral anterior and ipsilateral posterior territories, respectively, imparting mild hypothermia (35 and 35.5 °C respectively). The mA1 and fP1 variants allowed for sufficient cooling of the middle cerebral territory (30-32 °C).The simulations suggest that ICSI is feasible and may be the fastest method of inducing hypothermia. Moreover, the effect of convective heat transfer via the complete CoW and its variants underlies the important role of CoW anatomy in intracerebral temperature distributions during SBC.
