Fever following intracerebral and intraventricular hemorrhage

Although it is a well-recognized sequela, the clinical course of fever following intracerebral hemorrhage (ICH) and intraventricular hemorrhage (IVH) with or without ICH has not been well-studied. Patients with fever following either ICH or IVH routinely undergo extensive testing only to conclude that the fever is "central" in origin. We performed a retrospective analysis of the clinical course of fever following isolated IVH, ICH, or IVH associated with ICH. Records of 49 patients with ICH and/or IVH who were admitted to the Cleveland Clinical Foundation from 1987 to 1991 were studied for the onset, duration and degree of temperature following the hemorrhage. The incidence of fever was 83.3% in 6 patients with isolated IVH, 52% in 25 patients with isolated ICH, and 88.8% in 18 patients with both ICH and IVH. The highest temperature reached was 40.6°C in a patient with basal ganglia, third, and fourth ventricular hemorrhage. The fever lasted from 1 to 40 days. The fever could be attributed to infection in only 4 patients, and none of the patients with fever had proven deep vein thrombosis.