Neuroprotection or increased brain damage mediated by temperature in stroke is time dependent

Area of Science:

• Neurology
• Clinical Medicine
• Therapeutics

Background:

• Body temperature control is a potential therapeutic target in acute stroke.
• The precise timing and impact of temperature fluctuations on stroke outcomes require further investigation.

Purpose of the Study:

• To investigate the association between body temperature changes within the initial 72 hours and patient outcomes in ischemic (IS) and hemorrhagic (ICH) stroke.
• To establish the therapeutic window for temperature modulation in stroke management.

Main Methods:

• Prospective study of 2931 stroke patients (2468 IS, 463 ICH).
• Body temperature recorded at admission and at 24, 48, and 72 hours post-admission.
• Temperature categorized as low (<36°C), normal (36-37°C), and high (>37°C).
• Functional outcome assessed at 3 months using the modified Rankin Scale.

Main Results:

• Stroke patients exhibited higher temperatures than controls, with a gradual increase in the first 72 hours.
• High temperature at 24 and 48 hours post-stroke was significantly associated with poor functional outcomes (OR 2.05 and 1.93, respectively).
• Low temperature showed a potential neuroprotective effect within the first 24 hours.

Conclusions:

• Elevated body temperature in the first 48 hours after stroke is linked to adverse outcomes.
• Temperature management, particularly avoiding hyperthermia in the early phase, is critical for improving stroke patient prognosis.
• The findings suggest a narrow therapeutic window for temperature interventions in acute stroke.