Supratentorial hemorrhag

Many head-injured patients experience fever, and recent data indicate that bladder temperature and rectal temperature often underrepresent brain temperature after TBI, particularly when the patient is hypo-or hyperthermic (21). In that study, brain temperature was usually greater than rectal or bladder temperature in adults with severe brain injury. In another study, the duration of fever was reported to be associated with poor outcome in patients with supratentorial hemorrhage (5). Taken together, these experimental and clinical findings (4,5) indicate that fever should be aggressively treated when core temperature is mildly elevated above normal levels (22,23). 

Insertion of a ventricular catheter can be life saving in patients with cerebellar hemorrhage and hydrocephalus. In patients with supratentorial hemorrhage and hydrocephalus, however, the benefits of cerebrospinal fluid (CSF) diversion are less certain. In patients with extensive intraventricular hemorrhage secondary to deep intraparenchymal or aneurysmal rupture, drainage of CSF is performed in some centers. Systematic reviews of observational studies suggest that this procedure may be helpful, especially when it is combined with instillation of fibrinolytic drugs. However, randomized trials are needed (Lee et al. 2003 Fountas et al. 2005). 

Recently, Szczudliket al. (4) studied 152 patients with supratentorial primary intracerebral hemorrhage (PICH) confirmed by CT on admission. In that study, outcome was measured by either mortality or Barthel... 

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