Devices and methods for providing focal cooling to the brain and spinal cord
Systems and methods for systems and methods for focal cooling of the brain and spinal cord are disclosed. Some embodiments may be directed to a neuroprotection system that includes a cerebrospinal fluid processing platform. Embodiments may provide rapid and selective spinal cord hypothermia and drainage. Embodiments may be tailored to selective spinal cord cooling, pressure monitoring and automated drainage. Embodiments may enable local hypothermic neuroprotection, limit the stress of systemic cooling, minimize secondary neuronal damage and achieve maximal neuroprotection while at the same time improving workflow as a result of automated drainage. Embodiments may include a multi-lumen catheter, a drainage collection reservoir bag, a pump to circulate coolant, sensor hardware and controllers to modulate the flow of a heat transfer fluid for cooling to modulate therapeutic hypothermia and re-warming. Certain embodiments may include extracorporeal cooling of cerebrospinal fluid (CSF). Certain embodiments may include circulating heat transfer fluid within a CSF-containing space near the brain or spinal cord using a catheter. Particular methods may be used to determine the length and amount of cooling.
1. A method for providing focal cooling at a treatment site of a human or animal subject using a treatment system to treat a subarachnoid hemorrhage, a thoraco-abdominal aortic aneurysm, a fever, a seizure condition, an intracerebral hemorrhage, cerebral ischemia, hydrocephalus, a cerebrospinal fluid (CSF) leak, a traumatic brain injury, or inflammation, the method comprising:
deploying a catheter at or near the treatment site;
withdrawing CSF near the treatment site through an inlet lumen of the catheter;
reducing the temperature of the withdrawn CSF;
returning the withdrawn CSF to the subject;
measuring a rate of temperature change at the treatment site using a sensor;
comparing the measured rate of temperature change with a target rate of temperature change; and
modifying a treatment parameter if the rate of temperature changes differs from the target rate of temperature change.
2. The method of claim 1 , wherein the treatment site comprises at least one of brain parenchyma of the subject or spinal cord tissue of the subject.
3. The method of claim 1 , further comprising filtering the withdrawn CSF.
4. The method of claim 3 , further comprising filtering cytokines from the withdrawn CSF.
5. The method of claim 1 , wherein the treatment parameter is a rate at which the CSF is withdrawn, a rate at which CSF is returned, or a temperature to which the temperature of the CSF is reduced.
6. A method for providing focal cooling at a treatment site of a human or animal subject using a treatment system to treat a subarachnoid hemorrhage, a thoraco-abdominal aortic aneurysm, a fever, a seizure condition, an intracerebral hemorrhage, cerebral ischemia, hydrocephalus, a cerebrospinal fluid (CSF) leak, a traumatic brain injury, or inflammation, the method comprising:
deploying a catheter at or near the treatment site;
passing a heat transfer fluid through a lumen of the catheter;
measuring a rate of temperature change at the treatment site using a sensor;
comparing the measured rate of temperature change with a pre-determined target rate of temperature change;
modifying a treatment parameter when the measured rate of temperature change differs from the pre-determined target rate of temperature change.
7. The method of claim 6 , wherein the method further comprises placing an outer surface of an inflatable section of the catheter in proximal contact with tissue near the treatment site by inflating the inflatable section, the outer surface comprising a cooling section configured to facilitate the cooling of the tissue by the heat transfer fluid.
8. The method of claim 7 , wherein inflating the inflatable section comprises filling the inflatable section with heat transfer fluid.
9. The method of claim 7 , wherein the outer surface of the inflatable section comprises a pathway through which the heat transfer fluid flows.
10. The method of claim 6 , wherein the characteristic is temperature, intracranial pressure, or electrical activity.
11. The method of claim 6 , wherein the treatment site comprises at least one of brain parenchyma of the subject or spinal cord tissue of the subject.
12. The method of claim 6 , further comprising withdrawing CSF at or near the treatment site through an inlet lumen of the catheter.
13. The method of claim 12 , further comprising filtering the withdrawn CSF.
14. The method of claim 12 , further comprising reducing the temperature of the withdrawn CSF and returning the withdrawn CSF through an outlet lumen of the catheter.
15. The method of claim 14 , wherein the treatment parameter is a rate at which the CSF is withdrawn, a rate at which CSF is returned, or a temperature to which the temperature of CSF is reduced.
16. A method for providing focal cooling, the method comprising:
disposing a catheter adjacent to a target location;
withdrawing cerebrospinal fluid from the target location through an inlet lumen of the catheter;
cooling the withdrawn cerebrospinal fluid;
returning the cooled cerebrospinal fluid to the target location;
measuring a rate of temperature change at the treatment site using a sensor;
comparing the rate of temperature change with a pre-determined target rate of temperature change; and
modifying a flow rate at which the cooled cerebrospinal fluid is returned to the target location if the rate of temperature changes differs from the target rate of temperature change.
17. The method of claim 16 , further comprising filtering the withdrawn cerebrospinal fluid.
18. The method of claim 16 , wherein modifying a flow rate at which the cooled cerebrospinal fluid is returned to the target location if the rate of temperature changes differs from the target rate of temperature change includes reducing the flow rate at which the cooled cerebrospinal fluid is returned to the target location.
19. The method of claim 16 , wherein modifying a flow rate at which the cooled cerebrospinal fluid is returned to the target location if the rate of temperature changes differs from the target rate of temperature change includes increasing the flow rate at which the cooled cerebrospinal fluid is returned to the target location.