Brain temperature, body core temperature, and intracranial pressure in acute cerebral damage

Abstract

Objectives-To assess the frequency of hyperthermia in a population of acute neurosurgical patients; to assess the relation between brain temperature (ICT) and core temperature (Tc); to investigate the eVect of changes in brain temperature on intracranial pressure (ICP). Methods-The study involved 20 patients (10 severe head injury, eight subarachnoid haemorrhage, two neoplasms) with median Glasgow coma score (GCS) 6. ICP and ICT were monitored by an intraventricular catheter coupled with a thermistor. Internal Tc was measured in the pulmonary artery by a Swan-Ganz catheter. Conclusions-Fever is extremely frequent during acute cerebral damage and ICT is significantly higher than Tc. Moreover, Tc may underestimate ICT during the phases when temperature has the most impact on the intracranial system because of the close association between increases in ICT and ICP. (J Neurol Neurosurg Psychiatry 2001;71:448-454) Results-Mean

Brain Temperature in Patients With Chronic Hydrocephalus After Subarachnoid Hemorrhage

“…8) Pyrexia is common in the acute stage of severe neurological disease and cerebral metabolism increases more than systemic metabolism due to the rise in temperature. 8) We previously observed that the difference between ventricular and rectal temperatures was greater in patients requiring continuous ventricular drainage for acute hydrocephalus due to SAH, intracerebral hematoma, or brain tumor, than in patients with chronic hydrocephalus due to various etiologies. 5) However, brain temperature might vary depending on the phase of the clinical course.…”

“…The temperature of the brain depends on three major factors: local heat production, cerebral blood flow, and the temperature of the perfusing blood. 8) T. Omori et al…”

Perioperative temperature measurement and management: moving beyond the Surgical Care Improvement Project

“…In the severely brain-injured population, jugular vein temperature more accurately represents core body temperature instead of brain temperature. The difference becomes greater if the patient is febrile [26,27]. In a study by Rumana et al, the difference between jugular bulb and intraparenchymal brain temperature did not correlate with a decrease in global cerebral flow, injury severity, or type of injury [25].…”

“…In fact, a two-to four-degree difference may exist [25][26][27]. In the severely brain-injured population, jugular vein temperature more accurately represents core body temperature instead of brain temperature.…”

“…A solution to monitoring core temperature sites in lieu of cerebral temperature for non-severely brain injured patients, for whom large rapid changes in temperature during surgery are anticipated, is to monitor multiple sites to help identify outliers [16]. Since core body temperature provides a fair approximation of brain temperature [16], except in cases of severe brain injury [25][26][27], and rapid changes in body temperature [16], it may partially explain why hypothermia based on core temperature measurements provides neuroprotection.…”