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Abstract
Objective: Both brain and body temperature rise after stroke but the cause of each is uncertain. We investigated the relationship between circulating markers of inflammation with brain and body temperature after stroke.
Methods: We recruited patients with acute ischemic stroke and measured brain temperature at hospital admission and 5 days after stroke with multivoxel magnetic resonance spectroscopic imaging in normal brain and the acute ischemic lesion (defined by diffusion-weighted imaging [DWI]). We measured body temperature with digital aural thermometers 4-hourly and drew blood daily to measure interleukin-6, C-reactive protein, and fibrinogen, for 5 days after stroke.
Results: In 44 stroke patients, the mean temperature in DWI-ischemic brain soon after admission was 38.4°C (95% confidence interval [CI] 38.2–38.6), in DWI-normal brain was 37.7°C (95% CI 37.6–37.7), and mean body temperature was 36.6°C (95% CI 36.3–37.0). Higher mean levels of interleukin-6, C-reactive protein, and fibrinogen were associated with higher temperature in DWI-normal brain at admission and 5 days, and higher overall mean body temperature, but only with higher temperature in DWI-ischemic brain on admission.
Conclusions: Systemic inflammation after stroke is associated with elevated temperature in normal brain and the body but not with later ischemic brain temperature. Elevated brain temperature is a potential mechanism for the poorer outcome observed in stroke patients with higher levels of circulating inflammatory markers.
GLOSSARY
- CI=
- confidence interval;
- DVT=
- deep venous thrombosis;
- DWI=
- diffusion-weighted imaging;
- FLAIR=
- fluid-attenuated inversion recovery;
- FOV=
- field of view;
- 1H MRSI=
- proton magnetic resonance spectroscopy imaging;
- IL-6=
- interleukin-6;
- IQR=
- interquartile range;
- MR=
- magnetic resonance;
- MRS=
- magnetic resonance spectroscopy;
- NIHSS=
- NIH Stroke Scale;
- PRESS=
- point resolved spectroscopy
Footnotes
-
Study funding: This work was funded by a grant from The Stroke Association (Registered Charity SC037789), Project Ref No: TSA 2006/11. B.K. is supported by the Foundation for Polish Science and the International Brain Research Organization (IBRO). J.M.W. is supported by the Scottish Funding Council through the Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration (www.sinapse.ac.uk). W.W. was supported the Chief Scientist's Office (CAF/06/30) and is now funded by a Clinician Scientist Fellowship from the UK Medical Research Council (G0902303). The study funders and sponsors had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.
- Received October 31, 2011.
- Accepted February 29, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
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- Brain temperature and ischemic stroke
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