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Neurogenic hyperthermia in subarachnoid hemorrhage
R K Simpson1, D K Fischer, B L Ehni
1Department of Neurosurgery, Baylor College of Medicine, Houston, Tex. 77030.
Southern Medical Journal
|December 1, 1989
Summary
Neurogenic hyperthermia in a patient with diencephalic infarction was treated successfully with cyproheptadine and indomethacin. These drugs targeted serotonin and prostaglandin pathways, offering a novel treatment for refractory fever.
Area of Science:
- Neurology
- Endocrinology
Background:
- Diencephalic infarction can lead to hypothalamic dysfunction and subsequent neurogenic hyperthermia.
- Aneurysmal subarachnoid hemorrhage can cause cerebral vasospasm, contributing to diencephalic injury.
Observation:
- A patient presented with persistent, refractory hyperthermia unresponsive to standard treatments.
- The hyperthermia was attributed to hypothalamic dysfunction secondary to cerebral vasospasm.
Findings:
- Treatment with cyproheptadine and indomethacin effectively reduced the patient's body temperature.
- These medications likely acted by antagonizing serotonin and prostaglandin pathways involved in thermoregulation.
Implications:
- Cyproheptadine and indomethacin represent a potential therapeutic strategy for neurogenic hyperthermia.
- Understanding the role of serotonin and prostaglandins in fever regulation may open new avenues for treatment.