Neurosurgery and Brain Health Fighting Traumatic Brain Injury with Extreme Cold: A Survival Story By Neurosurgery, August 7, 2014 On a snowy winter night, eight-year-old Justin Roe made a phone call. “Feel good, Dad. I love you, Dad,” he said. “I hope that I’ll see you soon. Then we will go fishing and ride dirt bikes.” But there was no one listening on the other end. Justin’s father, Josh, was unconscious in the ER. He had sustained a traumatic brain injury, and his life hung in the balance. All Justin could do was leave a voicemail for his dad and hope he would wake up to hear it. Hours before Justin’s call, Josh was with some friends and decided to go get a bite to eat. But only a few hundred yards from the restaurant, the car he was riding in was broadsided by a bread truck. The car was destroyed and pieces of it lay scattered across the road. Within minutes, paramedics arrived at the scene and extracted Josh from the car. Josh had no response to light, sound, or touch. A helicopter was immediately called to transport Josh to the UPMC Presbyterian trauma center, where a team of trauma experts was ready to do everything possible to save the young father’s life. Because of the significant amount of force Josh’s head sustained in the accident, he had a severe traumatic brain injury. His brain was beginning to shut down. Doctors informed his family that his situation was extremely critical, and Justin was afraid that his time with his father had been cut short. “I thought I would never get to see my dad again,” he said. Then, a UPMC neurosurgeon recommended Josh as the first patient in a clinical trial. The innovative new treatment would involve cooling Josh’s brain to help minimize damage, reduce swelling, and promote healing so Josh could have a better chance of survival. This process, used for only the most serious cases of traumatic brain injury, involves a full-body cooling suit that chills the brain to the point of hypothermia. It works by sending a constant flow of water over the body, while a thin hydrogel coating ensures constant contact with the skin. With his brain cooled to 91.4 degrees Fahrenheit, several degrees below the 95 degree mark that indicates hypothermia, Josh’s brain swelling began to stabilize. His team of doctors were able to control the pressure inside his head, creating the right set of circumstances to maximize his recovery. Because of this trial, Justin’s dad beat the odds and survived. After two weeks, doctors decided Josh’s brain was healthy enough to take him out of the medically-induced coma. Josh remained in intensive care until he gained enough strength to be transferred to the UPMC Rehabilitation Institute’s brain injury unit. At this point, Josh couldn’t walk, feed himself, or use the left side of his body, and he had to fight to recover the little things that most people take for granted each day. Josh had a long road to recovery, but he knew he had to survive for his son. “I started pushing myself because I wanted to get back to where I was,” he said. “I couldn’t give up on things. I knew that I had to continue to do the things that I did before the accident, so that I could retrain my brain to do them again.” Several years later, Josh Roe is near full recovery, and Justin is happy to have his father back at his side. “It’s nothing I ever imagined,” said Justin. For more inspiring stories like Josh’s and to learn more about discoveries made in the field, please visit the UPMC Department of Neurosurgery website or call 1-877-986-9862 to make an appointment.