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Fever is associated with third ventricular shift after intracerebral hemorrhage: pathophysiologic implications
Anupa Deogaonkar1, Michael De Georgia, Charles Bae
1Department of Neurology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Neurology India
|July 13, 2005
Summary
Fever is common after intracerebral hemorrhage (ICH) and linked to increased ICH volume and third ventricular shift. This suggests hypothalamic compression may cause central fever, potentially worsening patient outcomes.
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Background:
- Increased temperature negatively impacts brain injury outcomes.
- Fever is a frequent complication following intracerebral hemorrhage (ICH).
- Central fever is diagnosed when no other cause of fever is identified.
Purpose of the Study:
- To investigate the relationship between fever and third ventricular shift in patients with ICH.
- To explore the potential mechanism behind fever development in ICH patients.
Main Methods:
- A prospective observational study was conducted in a Neurointensive Care Unit.
- Data from 61 ICH patients were collected, including temperature, ICH volume, and third ventricular shift.
- Statistical analyses included Spearman correlation, Mann-Whitney test, and logistic regression.
Main Results:
- Fever was observed in 56% of patients within 24 hours and 53% for at least two consecutive days.
- ICH volume correlated with maximum temperature and fever at 24 and 72 hours.
- Third ventricular shift correlated with maximum temperature at 72 hours and was associated with fever and worse outcomes.
Conclusions:
- Fever is prevalent post-ICH and associated with ICH volume and third ventricular shift.
- Findings suggest hypothalamic compression may contribute to central fever.
- Fever at 72 hours correlated with higher mortality and a trend towards worse neurological scores.