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This Article Full Text Free Full Text (PDF) Free All Versions of this Article: 103/5/1837    most recent 00542.2007v1 Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Neimark, M. A. Articles by Pile-Spellman, J. Search for Related Content PubMed PubMed Citation Articles by Neimark, M. A. Articles by Pile-Spellman, J.

Integration of jugular venous return and circle of Willis in a theoretical human model of selective brain cooling

Departments of ¹Biomedical Engineering and ²Radiology, Columbia University, New York, New York; and ³Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts

Submitted 18 May 2007 ; accepted in final form 24 August 2007

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 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 min. 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.

intracarotid saline infusion; intracerebral vascular flow rates; therapeutic hypothermia