Unfortunately most teaching books refer only to the extracellular magnesium as the blocking mechanism. Hypothermia + magnesium work by a synergistic effect and that's why almost all trials with magnesium or hypothermia alone have failed, not only in tbi but also in stroke etc.
On the other hand hypothermia increases H+ concentration and this pushes magnesium inside the cels. Still it needs to be high enough for the concentration gradient to work. Most drugs fail (calcium channel blockers) because there are distinct binding sites for the NMDA receptor (intracellular + extracellular Mg+).
Hypothermia alone will never work Dr. George Lundberg unless combined with magnesium. I wish you doctors understood the synergistic effect of combined hypothermia and magnesium. Magnesium is missing after brain injury. Magnesium alone won't go inside the cells and calcium overload is the primary reason for the neurometabolic cascade.
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