Introduction: Controlled hypothermia is a very promising neuroprotective method usable primarily in the area of neurotraumatology, since it effectively decreases intracranial pressure (ICP) and increases cerebral perfusion pressure (CPP). However, the effect on long-term therapeutic outcome has not been unequivocally demonstrated. The goal of our study was to find out, whether hypothermia shows different effects in patients with dominating primary brain injury and in patients with brain compression by extracerebral haematomas. Material and methods:A total of 60 patients with severe brain injury (GCS <=8) were divided in two groups of 30 patients each (one hypothermic, one normothermic) and these were subdivided further according to CT findings into patients with primary brain injury and with brain compression. Results: In both hypothermic patient groups, CPP was statistically significantly increased compared to normotheramic patients (normothermia x hypothermia: 74±6 x 79±6 mm Hg in primary injury and 71±2 x 79±6 mm Hg in brain compression). Therapeutic outcome (Glasgow Outcome Score) 6 months after injury was statistically significantly improved only in hypothermic patients with brain compression (2.89±1.7 x 4.67±0.5). Conclusion: With adequate monitoring, mild controlled hypothermia improves therapeutic outcome in patients threatened with secondary ischemic damage to the brain. In primary injuries, it should only be used in cases of intracranial hypertension that cannot be managed otherwise.

        Key words: severe brain injury, controlled hypothermia