High Temperature Immediately Following A Stroke Leads To Worse Outcome; Quick Cooling Shown To Have Benefit

December 03, 1998

DALLAS, Dec. 4 -- Abnormally high body temperature within 24 hours of having a stroke may increase risk for death, according to a study in this month's Stroke: Journal of the American Heart Association. Reducing body temperature immediately after a stroke can reduce the death rate from stroke, according to another study in the same issue.

Spanish researchers examining 260 patients with stroke found the relationship between brain damage and high body temperature is greater when the temperature increase occurs immediately after the stroke. Only one percent of the patients with a normal body temperature died three months after the stroke. Among the 158 patients who had a high temperature immediately after the stroke, 15.8 percent of them died within three months.

In 57.6 percent with hyperthermia, or high body temperature, infection was the culprit. The death rate was much greater in people who had infectious hyperthermia (22 percent) than those with non-infectious hyperthermia (7.5 percent).

"Hyperthermia is of greatest concern when it begins within 24 hours of a stroke," says the study's lead author, Jose Castillo, M.D., of the Hospital Xeral de Galicia in Santiago de Compostela, Spain. "Our efforts should be directed toward immediate reduction of body temperature when it is greater than 37.5 degrees Celsius (99.5 degrees Fahrenheit)."

Reducing body temperature was the focus of a German study in this month's Stroke: Journal of the American Heart Association. Scientists say that lowering body temperature by using cooling blankets, cold infusions or cold washing may relieve pressure in the brain after a stroke and can improve the patients' outcome.

Of the 25 patients in the study who suffered a severe stroke in their middle cerebral artery and whose body temperatures were lowered, 14 survived. On average, the survivors' neurological scores -- based on tests to determine brain function -- improved in the three months after the stroke. For those who died, the cause of death was due to increased pressure in the brain during the rewarming process.

"In this kind of stroke, there's a death rate of about 80 percent," says the study's lead author, Stefan Schwab, M.D., of the University of Heidelberg, Germany. "Cooling the body helps to relieve pressure in the brain."

It took between 3.5 to 6.2 hours to cool the stroke patients to 33 degrees Celsius (91.4 degrees Fahrenheit), which was sustained for 48 to 72 hours. Pneumonia was the most frequent complication, occurring in 10 of the 25 patients.
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NR 98-4593 (Stroke/Brief)

Media advisory: Dr. Castillo's co-author, Dr. Antoni Davalos, can be reached by phone at 34-972-202700, ext. 282 and 390, by fax at 34-972-212754 or by e-mail at adavalose@meditex.es. Dr. Schwab can be reached by phone at 49-6221-566-106, by fax at 49-6221-565-348 or by e-mail at Stefan_Schwab@ukl.uni_heidelberg.de. (Please do not publish numbers.)

For journal copies only,
please call (214) 706-1173 or 1396

For other information, call
Brian Henry: (214) 706-1135 or
Carole Bullock: (214) 706-1279
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American Heart Association

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