The thermodynamic brain

Apart from its complex functionality, the brain is a robust thermodynamic machine; the tissue metabolic rate is high and it is thermally shielded by a skull. Therefore, if there is no high-volume blood flow to cool and stabilize the brain temperature, the possibility of unstable behavior seems to be high. Inflowing arterial blood is normally cooler than the brain tissue temperature, and outflowing venous blood is normally warmer than arterial blood but cooler than the brain tissue. Brain blood flow can thus be understood as a cooler for the brain. Pros and cons of clinical measurement, with clear indication for a multimodal monitoring approach, are discussed along with a brief review of basic facts known about temperature, cerebral blood flow and volume, intracranial pressure, and compartmental compliances of the brain.