Brain temperature but not core temperature increases during spreading depolarizations in patients with spontaneous intracerebral hemorrhage

Abstract

Spreading depolarizations (SDs) are highly active metabolic events, commonly occur in patients with intracerebral hemorrhage (ICH) and may be triggered by fever. We investigated the dynamics of brain-temperature (T) and core-temperature (T) relative to the occurrence of SDs. Twenty consecutive comatose ICH patients with multimodal electrocorticograpy (ECoG) and T monitoring of the perihematomal area were prospectively enrolled. Clusters of SDs were defined as ≥2 SDs/h. Generalized estimating equations were used for statistical calculations. Data are presented as median and interquartile range. During 3097 h (173 h [81-223]/patient) of ECoG monitoring, 342 SDs were analyzed of which 51 (15%) occurred in clusters. Baseline T and T was 37.3℃ (36.9-37.8) and 37.4℃ (36.7-37.9), respectively. T but not T significantly increased 25 min preceding the onset of SDs by 0.2℃ (0.1-0.2; p < 0.001) and returned to baseline 35 min following SDs. During clusters, T increased to a higher level (+0.4℃ [0.1-0.4]; p = 0.006) when compared to single SDs. A higher probability (OR = 36.9; CI = 36.8-37.1; p < 0.001) of developing SDs was observed during episodes of T ≥ 38.0℃ (23% probability), than during T ≤ 36.6℃ (9% probability). Spreading depolarizations - and in particular clusters of SDs - may increase brain temperature following ICH.

Simian immunodeficiency virus transiently increases brain temperature in rhesus monkeys: detection with magnetic resonance spectroscopy thermometry

“…Although rectal temperatures predicted and thus could serve as surrogate markers for brain temperatures in SIV‐infected monkeys under the conditions we studied, brain temperatures do not always correlate with peripheral temperature measures . Thus, brain temperature can be a useful independent measure and could be informative in other brain disorders, including in major depression, which is associated with inflammation, as well as in addiction disorders, psychotic disorders, seizure disorders, and stroke …”

“…32,33 Thus, brain temperature can be a useful independent measure and could be informative in other brain disorders, including in major depression, which is associated with inflammation, [50][51][52] as well as in addiction disorders, 32,53,54 psychotic disorders, [55][56][57] seizure disorders, 58 and stroke. 59,60…”

Inflammation, edema and poor outcome are associated with hyperthermia in hypertensive intracerebral hemorrhages

“…We determined that each °C of body temperature is associated with about 30% more risk of dying or being dependent at 3 months. Results are in line with clinical and pre‐clinical studies on the deleterious effect of hyperthermia and fever in different neuronal pathologies . This study shows that hypertensive patients with ICH with a body temperature in the first 24 h ≥ 37.5°C have a 5.3‐fold higher risk of poor outcome at 3 months.…”

Magnetic Resonance Spectroscopy Thermometry at 3 Tesla: Importance of Calibration Measurements

“…In patients suffering from TBI deviations exceeding 2°C have been detected (Rumana et al, 1998) by invasive monitoring of brain temperature simultaneously to body core temperature. This is supported by the observation that brain temperature increases independently of body core temperature during spreading depolarizations in patients with spontaneous intracerebral hemorrhage (Schiefecker et al, 2018). Temperatures measured tympanically, rectally, or in the urinary bladder reflect tendencies in brain temperature rather than absolute brain temperature with a consideration to an inaccuracy of probes of about 0.1°C-0.2°C and a temperature gradient occurring between these measuring sites (Mariak et al, 1994;Childs and Machin, 2009;Rango et al, 2012;Karaszewski et al, 2013).…”