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Relationships between brain and body temperature, clinical and imaging outcomes after ischemic stroke

Pyrexia soon after stroke is associated with severe stroke and poor functional outcome. Few studies have assessed brain temperature after stroke in patients, so little is known of its associations with body temperature, stroke severity, or outcome. We measured temperatures in ischemic and normal-app...

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Autores principales: Karaszewski, Bartosz, Carpenter, Trevor K, Thomas, Ralph G R, Armitage, Paul A, Lymer, Georgina Katherine S, Marshall, Ian, Dennis, Martin S, Wardlaw, Joanna M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705437/
https://www.ncbi.nlm.nih.gov/pubmed/23571281
http://dx.doi.org/10.1038/jcbfm.2013.52
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author Karaszewski, Bartosz
Carpenter, Trevor K
Thomas, Ralph G R
Armitage, Paul A
Lymer, Georgina Katherine S
Marshall, Ian
Dennis, Martin S
Wardlaw, Joanna M
author_facet Karaszewski, Bartosz
Carpenter, Trevor K
Thomas, Ralph G R
Armitage, Paul A
Lymer, Georgina Katherine S
Marshall, Ian
Dennis, Martin S
Wardlaw, Joanna M
author_sort Karaszewski, Bartosz
collection PubMed
description Pyrexia soon after stroke is associated with severe stroke and poor functional outcome. Few studies have assessed brain temperature after stroke in patients, so little is known of its associations with body temperature, stroke severity, or outcome. We measured temperatures in ischemic and normal-appearing brain using (1)H-magnetic resonance spectroscopy and its correlations with body (tympanic) temperature measured four-hourly, infarct growth by 5 days, early neurologic (National Institute of Health Stroke Scale, NIHSS) and late functional outcome (death or dependency). Among 40 patients (mean age 73 years, median NIHSS 7, imaged at median 17 hours), temperature in ischemic brain was higher than in normal-appearing brain on admission (38.6°C-core, 37.9°C-contralateral hemisphere, P=0.03) but both were equally elevated by 5 days; both were higher than tympanic temperature. Ischemic lesion temperature was not associated with NIHSS or 3-month functional outcome; in contrast, higher contralateral normal-appearing brain temperature was associated with worse NIHSS, infarct expansion and poor functional outcome, similar to associations for tympanic temperature. We conclude that brain temperature is higher than body temperature; that elevated temperature in ischemic brain reflects a local tissue response to ischemia, whereas pyrexia reflects the systemic response to stroke, occurs later, and is associated with adverse outcomes.
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spelling pubmed-37054372013-07-09 Relationships between brain and body temperature, clinical and imaging outcomes after ischemic stroke Karaszewski, Bartosz Carpenter, Trevor K Thomas, Ralph G R Armitage, Paul A Lymer, Georgina Katherine S Marshall, Ian Dennis, Martin S Wardlaw, Joanna M J Cereb Blood Flow Metab Original Article Pyrexia soon after stroke is associated with severe stroke and poor functional outcome. Few studies have assessed brain temperature after stroke in patients, so little is known of its associations with body temperature, stroke severity, or outcome. We measured temperatures in ischemic and normal-appearing brain using (1)H-magnetic resonance spectroscopy and its correlations with body (tympanic) temperature measured four-hourly, infarct growth by 5 days, early neurologic (National Institute of Health Stroke Scale, NIHSS) and late functional outcome (death or dependency). Among 40 patients (mean age 73 years, median NIHSS 7, imaged at median 17 hours), temperature in ischemic brain was higher than in normal-appearing brain on admission (38.6°C-core, 37.9°C-contralateral hemisphere, P=0.03) but both were equally elevated by 5 days; both were higher than tympanic temperature. Ischemic lesion temperature was not associated with NIHSS or 3-month functional outcome; in contrast, higher contralateral normal-appearing brain temperature was associated with worse NIHSS, infarct expansion and poor functional outcome, similar to associations for tympanic temperature. We conclude that brain temperature is higher than body temperature; that elevated temperature in ischemic brain reflects a local tissue response to ischemia, whereas pyrexia reflects the systemic response to stroke, occurs later, and is associated with adverse outcomes. Nature Publishing Group 2013-07 2013-04-10 /pmc/articles/PMC3705437/ /pubmed/23571281 http://dx.doi.org/10.1038/jcbfm.2013.52 Text en Copyright © 2013 International Society for Cerebral Blood Flow & Metabolism, Inc. http://creativecommons.org/licenses/by-nc-nd/3.0/ This work is licensed under the Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/
spellingShingle Original Article
Karaszewski, Bartosz
Carpenter, Trevor K
Thomas, Ralph G R
Armitage, Paul A
Lymer, Georgina Katherine S
Marshall, Ian
Dennis, Martin S
Wardlaw, Joanna M
Relationships between brain and body temperature, clinical and imaging outcomes after ischemic stroke
title Relationships between brain and body temperature, clinical and imaging outcomes after ischemic stroke
title_full Relationships between brain and body temperature, clinical and imaging outcomes after ischemic stroke
title_fullStr Relationships between brain and body temperature, clinical and imaging outcomes after ischemic stroke
title_full_unstemmed Relationships between brain and body temperature, clinical and imaging outcomes after ischemic stroke
title_short Relationships between brain and body temperature, clinical and imaging outcomes after ischemic stroke
title_sort relationships between brain and body temperature, clinical and imaging outcomes after ischemic stroke
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705437/
https://www.ncbi.nlm.nih.gov/pubmed/23571281
http://dx.doi.org/10.1038/jcbfm.2013.52
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