The Brain Tourniquet: Physiological Isolation of Brain Regions Damaged by Traumatic Head Injury

Abstract : The objective of this study was to assess the feasibility of the "brain tourniquet" concept, a new therapeutic approach to battlefield traumatic brain injury (TBI). The purpose of the brain tourniquet is to physiologically isolate damaged brain regions in order to allow head-injured warfighters to remain combat effective after sustaining brain trauma. This will also enhance recovery from this type of injury by preventing the spread of damage into otherwise healthy brain tissue and extending the "golden hour" to reach comprehensive medical care. As such, the ultimate goal of the brain tourniquet is two-fold: 1) physiologically isolate injured brain regions to halt (or at least delay) the spread of neurological damage to uninjured brain areas, such as excitotoxicity, and 2) maintain or enhance normal physiological function in the intact, uninjured brain regions to preserve any remaining cognitive and motor function. This dual requirement is dictated by the unique demands of the battlefield environment, in which incapacitation of brain function renders the warfighter completely defenseless. The critical feature of this approach is that, if successful, it will enable head-injured soldiers to continue to function in the combat setting (i.e., for self-defense) until comprehensive medical care or medical evacuation can be effected.