Body temperature infarction

Reith J, Jorgensen HS, Pedersen PM, Nakayama H, Raaschou HO, Jeppesen LL, Olsen TS. Body temperature in acute stroke relation to stroke severity, infarct size, mortality and outcome. Lancet 1996 347(1999) 422 25. 

Supportive therapy must be instituted to maintain adequate ventilation, euglycemia, blood pressure, and body temperature. Underlying disorders such as sepsis and myocardial infarction must be diagnosed and treated. 

The salicylates are also potent antipyretic agents, with the exception of diflunisal, which is only weakly active. Aspirin acts at two distinct but related sites. It decreases prostaglandin-induced fever in response to pyrogens and induces a decrease in interleukin-1 modulation of the hypothalamic control of body temperature. Thus, the hypothalamic control of body temperature returns, vasodilation occurs, heat dissipates, and fever decreases. Other uses of aspirin include inhibition of platelet aggregation via inhibition of thromboxanes, which has been shown to decrease the incidence of blood clots, myocardial infarction, and transient ischemic attacks. 

Meden P., Overgaard K., Pedersen H., and Boysen G. (1994) The influence of body temperature on infarct volume and thrombolytic therapy in a rat embolic stroke model. Brain Res. 647,131-138. 

Fig. 1. Relationship between size of infarction and body temperature during the acute phase of cardiogenic embolism. Analyzed using ANOVA, the difference in body temperature among the groups was statistically significant at any period during the first 3 d after of admission.

In a prospective study of 725 consecutive patients, 5 84 with cerebral infarcts and 141 with intracerebral hemorrhages, admitted to an acute stroke unit within 6 h of stroke onset, Boysen and Christensen measured body temperature on admission and every 2 h during the first 24 h after stroke onset (16). They found that, in patients with a major stroke (defined as having a Scandinavian Stroke Scale Score <25), a significant rise in temperature occurred hours after stroke onset. While severe infarcts and intracerebral hemorrhages caused temperature rises, elevated body temperature on admission within 6 h of stroke onset had no prognostic influence on stroke outcome at 3 mo. It is important to... 

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