All About Multiple Sclerosis

More MS news articles for May 2003

Cold helmet offers 'incredible' neurological' breakthrough

Peoria doctor's invention helps treat aneurysms, heart attacks, concussions

May 4, 2003

of the Journal Star

It can't be considered anything less than a medical breakthrough that could change the lives of countless patients worldwide each year.

Yet despite its far-reaching potential, this technology boasts no new discoveries, no elaborate scheme. In the most straight forward terms, it is a brilliantly simple concept that has been refined.

When Dr. John Wang began observing fevers in neuro intensive care patients, he contemplated how to capitalize on a fever's benefits while eliminating the detrimental neurological effects.

The cooling process has been pondered by endless physicians, but the particulars of previous methods left much to be desired. Some procedures cooled the entire body, negating a fever's infection and bacteria fighting ability. Others inconsistently transferred heat from the head.

So, in his first year as a neurosurgery resident at OSF Saint Francis Medical Center, Wang searched for a practical tool that would maximize the cooling effect's therapeutic value, while allowing unprecedented access to the head.

He found the answer in the National Aeronautics and Space Administration's space suits through a man considered to be one of the fathers of that technology.

"Equipment that needs to withstand those (temperature) extremes immediately piqued my curiosity," Wang said. "I started getting desperate because I couldn't find anything to suit my needs, so I started designing one myself."

A couple of years later, Wang's collaboration with Dr. William Elkins paid off. The cooling helmet has been used on head trauma and stroke victims with encouraging results. Preliminary studies also have shown the helmet's ability to affect epileptic seizures, potentially providing an alternative to medication.

And the applications don't end there. The helmet's benefits stretch into treatment of aneurysms, heart attacks, concussions, migraine headaches and even bipolar disorder. Wang hopes the helmet eventually becomes a standard fixture in ambulances, so paramedics can apply it at the earliest possible moment.

Dr. Susumu Sato, Chief of the EEG Section at the National Institute of neurological Disorders and Strokes, has been testing the helmet on epileptics, and believes the practice of cooling the brain on a regular basis could become an alternative to anti-seizure medication.

Sato said cooling the brain to interrupt seizures has been a common practice since the 1960s, but the introduction of the helmet allows patients regular usage, not merely application in times of trauma. His preliminary results indicate that routine treatment with the helmet decreases the frequency of seizures.

Extensive trials and testing, however, remain before the helmet graduates to become an accepted medical practice in any areas. Those efforts are currently underway.

Wang and his associate, Dr. David Wang, OSF Stroke Network director, presented preliminary data from a handful of head trauma and stroke patients to the National Institute of Health in December, when they requested funds to broaden the scope of clinical trials.

They are currently writing a multi-center proposal that they will present to the NIH in October. Dr. John Wang said several stroke treatment centers in February expressed interest in joining the study at the 28th annual International Stroke Conference in Phoenix.

"It's slow progress, but it's a sure progress," Wang said. "We need large numbers to establish clinical standards."

One of Wang's most promising cases has been a high school senior from Macomb. On her way to school at the beginning of this school year, the cheerleader lost control of her car and rolled it in a ditch. Firefighters extricated her from the wreckage using the jaws of life. She was flown from a hospital in Macomb to St. Francis in Peoria, where the helmet was administered 12 hours after the crash to prevent further swelling of her brain.

Without the helmet, the girl may have endured a surgery to remove part of her skull to relieve the inflammation. After a few comatose weeks and months relearning basic motor skills, she is back in school earning the same grades.

In her case, as in other applications, the helmet's purpose is to slow the brain's metabolic function by slowing the blood's delivery of oxygen, decreasing chances of permanent damage.

"Other organs - your liver or kidney - can take the insult for a couple hours," Wang explained. "Your brain can only take it for a much shorter time."

This phenomena has been proven by drowning victims, who have better odds of surviving without brain damage if submerged in cold water. The cooling helmet harnesses this morbid fact, and isolates its power. When discussing the helmet's design, Wang humbly diverts credit to Elkins, the spacesuit engineer.

Elkins' credentials read more like an adventure than a resume. He was a fighter pilot in and immediately after the Korean War. He holds the 1958 record for extended G loads, set when he tested a restraint system he designed for the Mercury Project.

He was awarded the Public Service Medal for training chemical defense and explosive ordinance disposal teams in Saudi Arabia for the first Persian Gulf War. He has been named a national resource by NASA's director of life sciences, and was inducted into the U.S. Space Foundation's Technology Hall of Fame in 1993.

The liquid cooling technology of which he is the sole creator has been used to aid people suffering from Multiple Sclerosis and hypohidroticectodermal dysplasia, or lack of sweat glands.

It was that technology that so interested Wang.

A predecessor to the cooling helmet, Elkins designed head gear and a vest for people with multiple sclerosis after finding out their symptoms dissipated in cooler temperatures. It was from this design that the cooling helmet emerged.

"(The M.S. cap) was similar in coverage but not detail," Elkins said. "The secret to the performance is a two-ply system."

Previous brain cooling techniques utilized ice or dry ice, which created moisture, an insulator, and pre-empted constant heat transfer from the patient to the material.

The cooling helmet, on the other hand, is pressurized to firmly fit around the skull. Frigid liquid courses between the inner and outer layers of the helmet, and leaves the face and ears exposed.

In addition to giving access to the eyes and air way, the design Elkins and Wang produced allows probes to directly access the brain through the cranium to measure the temperature, pressure and oxygen levels.

Because the helmet is pressurized, a few sizes can snugly fit infants through adults. Wang's data has shown the helmet can cool the brain by 2 degrees in 15 minutes.

Five such helmets exist today - two in Peoria, two at the NIH and one with Elkins in California.

The inventor made only a simple comment about the helmet: "It's incredible."

Copyright © 2003, The Peoria Journal Star Inc.