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Critical Care  2012 

Hypothermia in spinal cord injury

DOI: 10.1186/cc11270

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Other physicians like Hippocrates and Claudius Galen made historical reference to the management of spinal cord injury. Galen studied injuries in gladiators, and described 'that injury of the spinal cord caused paralysis and loss of sensation below the level of injury ... and determined that high spinal cord injuries are incompatible with life' [2,3].Chaulic Guy (1300 to 1360) carried out innovations in the management of traumatic bone injuries by introducing boards and suspensions to treat these fractures; however, he gave a pessimistic view on spinal injuries [4,5].Ambrose Pare (1510 to 1590) developed spine surgery, and along with Hildanus Fabricius (1560 to 1634) used traction techniques, reduction and utilization of wood frames to treat cervical spine fractures [6].Louis Pasteur's (1822 to 1895) surgical innovations and discoveries and the advent of asepsis and antisepsis by Semmelweis (1816 to 1868) and others, and primarily the application of general anesthesia by Morton (1819 to 1868) and others gave a new impulse to this field. Together these developments helped reduce surgical mortality and infections [5,7].In the nineteenth century, anatomy and physiology of the central nervous system were studied. The neuron doctrine was developed by Santiago Ramon y Cajal (1852 to 1934), who demonstrated the individuality of nerve cells and the connections that they have with each other [8,9].Alfred R Allen between 1908 and 1911 developed a reproducible and quantifiable model that allowed induction of a uniform traumatic injury to the spine, and also explained the pathophysiological changes seen in spinal trauma, including key aspects of secondary spinal cord injury. In 1972 Tarlov showed that symptoms caused by compression of the spinal cord for more than 12 hours could sometimes still be reversed. During this period 'progressive central hemorrhagic necrosis' was identified, which consists of bleeding from the gray matter of the spinal cord central necrosis and destruc


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