Differential interhemispheric cooling and ICP compartmentalization in a patient with left ICA occlusion.

We report a case of a 69-year-old white female who presented with a large left internal carotid artery occlusive stroke from a cardiogenic embolus. She was enrolled in an institutional study using a specially designed cooling helmet. Bilateral intracranial pressure (ICP) and temperature probes were placed to determine if there was any differential cooling and ICP compartmentalization between the two hemispheres. We demonstrated a significant temperature gradient between the infarcted and the non-infarcted hemisphere. A significant inter-hemispheric ICP gradient was also observed. We believe that this is the first demonstration of preferential cooling of the infarcted hemisphere over the non-infarcted hemisphere with regional surface hypothermia.