Relationships Between Brain and Body Temperature, Clinical and Imaging Outcomes after Ischemic Stroke

Karaszewski, Bartosz; Carpenter, Trevor; Thomas, Ruth; Armitage, Paul A.; Lymer, G. Katherine S.; Marshall, Ian; Dennis, Martin; Wardlaw, Joanna M.

doi:10.1038/jcbfm.2013.52

Cited by 50 publications

(49 citation statements)

References 37 publications

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“…A recent study [16] that used thermography in stroke patients (acute and subacute stage) indicated the use of this feature to monitor the function of both body sides in order to target the therapies of the rehabilitation team to asymmetry.…”

Section: Discussionmentioning

confidence: 99%

Use of Virtual Rehabilitation to Improve the Symmetry of Body Temperature, Balance, and Functionality of Patients with Stroke Sequelae

et al. 2018

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Background: Stroke rehabilitation that is based on the patients’ needs, experiences, and priorities requires extensive knowledge and skills to capture and integrate the perspectives of the subject. Purpose: The objective of this study was to evaluate the acute effect of an occupational therapy protocol associated with virtual reality (VR) on the symmetry of body temperature (BTP), balance, and functionality of patients with stroke sequelae. Methods: Ten patients (69.84 ± 7.55 years) diagnosed with stroke between 2 and 10 years earlier were evaluated during clinical care sessions integrated with VR games. Associated with games, all patients were stimulated to use both upper and lower limbs and distribute body weight symmetrically, and perceptual stimuli of body-half training, alignment, postural control, and balance were given. The variables of thermography (temperature [°C] and body asymmetry) of the upper and lower limbs, balance (Berg scale), and functionality were analyzed before and after the test. Results: BTP was reduced in the 4 upper and lower limb body regions of interest: the right arm (p = 0.024, Cohen’s d = 1.02), previous direct hand (p = 0.034, Cohen’s d = 1.22), right back hand (p = 0.003, Cohen’s d = 1.85) and Left (p = 0.013, Cohen’s d = 0.92), right thigh (p = 0.035, Cohen’s d = 1.32), and left thigh (p = 0.047, Cohen’s d = 0.92). The mean of the bilateral asymmetry variation of the arm in the anterior position at the pre test was classified according to the level of attention monitoring (which means that the asymmetry rate is above normal), changing its state at the end of the intervention to normal. There was an increase in the functional independence score (p = 0.015, Cohen’s d = 0.50) and in the static and dynamic balance function (p = 0.001, Cohen’s d = 0.07). Conclusion: VR associated with occupational therapeutic planning can amplify and potentiate neurological recovery following stroke.

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Section: Discussionmentioning

confidence: 99%

Use of Virtual Rehabilitation to Improve the Symmetry of Body Temperature, Balance, and Functionality of Patients with Stroke Sequelae

et al. 2018

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“…

Clinical (A) and neuroimaging (B) predictors for post-thrombolysis symptomatic intracranial haemorrhage in ischaemic stroke

A. Increasing age,9 higher National Institutes of Health Stroke Scale (NIHSS) score at admission,9 elevated blood pressure and serum glucose concentration,9 pretreatment use of aspirin and clopidogrel combined or alone (albeit not influencing outcome),9 105 a history of hypertension and/or statin prescription,9 congestive heart failure,9 ischaemic heart disease,9 atrial fibrillation,9 renal impairment 9

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Section: Introductionmentioning

confidence: 99%

What causes intracerebral bleeding after thrombolysis for acute ischaemic stroke? Recent insights into mechanisms and potential biomarkers

Karaszewski

Houlden

Smith

et al. 2015

J Neurol Neurosurg Psychiatry

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The overall population benefit of intravascular recombinant tissue plasminogen activator (rtPA) on functional outcome in ischaemic stroke is clear, but there are some treated patients who are harmed by early symptomatic intracranial haemorrhage (ICH). Although several clinical and radiological factors increase the risk of rtPA-related ICH, none of the currently available risk prediction tools are yet useful for practical clinical decision-making, probably reflecting our limited understanding of the underlying mechanisms. Finding new methods to identify patients at highest risk of rtPA-related ICH, or new measures to limit risk, are urgent challenges in acute stroke therapy research. In this article, we focus on the potential underlying mechanisms of rtPA-related ICH, highlight promising candidate risk biomarkers and suggest future research directions.

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“…Rather, a higher temperature in contralateral healthy brain tissue correlated with poorer National Institutes of Health Stroke Scale score, larger lesion size at 5 days, and worse functional outcome at 3 months. Body temperature elevation correlated with rise in contralateral normal brain tissue temperature, reflecting a mechanism of secondary brain injury as a result of a systemic response to the stroke (Karaszewski et al, 2013). These results encourage focused efforts on developing interventions to suppress the adverse physiological effects of stroke on healthy brain tissue.…”

Section: Ischemic Strokementioning

confidence: 78%

Fever Management Practices of Neuroscience Nurses

Rockett

Thompson

Blissitt

2015

Journal of Neuroscience Nursing

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Current evidence shows that fever and hyperthermia are especially detrimental to patients with neurologic injury, leading to higher rates of mortality, greater disability, and longer lengths of stay. Although clinical practice guidelines exist for ischemic stroke, subarachnoid hemorrhage, and traumatic brain injury, they lack specificity in their recommendations for fever management, making it difficult to formulate appropriate protocols for care. Using survey methods, the aims of this study were to (a) describe how nursing practices for fever management in this population have changed over the last several years, (b) assess if institutional protocols and nursing judgment follow published national guidelines for fever management in neuroscience patients, and (c) explore whether nurse or institutional characteristics influence decision making. Compared with the previous survey administered in 2007, there was a small increase (8%) in respondents reporting having an institutional fever protocol specific to neurologic patients. Temperatures to initiate treatment either based on protocols or nurse determination did not change from the previous survey. However, nurses with specialty certification and/or working in settings with institutional awards (e.g., Magnet status or Stroke Center Designation) initiated therapy at a lower temperature. Oral acetaminophen continues to be the primary choice for fever management, followed by ice packs and fans. This study encourages the development of a stepwise approach to neuro-specific protocols for fever management. Furthermore, it shows the continuing need to promote further education and specialty training among nurses and encourage collaboration with physicians to establish best practices.

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Relationships Between Brain and Body Temperature, Clinical and Imaging Outcomes after Ischemic Stroke

Cited by 50 publications

References 37 publications

Use of Virtual Rehabilitation to Improve the Symmetry of Body Temperature, Balance, and Functionality of Patients with Stroke Sequelae

Use of Virtual Rehabilitation to Improve the Symmetry of Body Temperature, Balance, and Functionality of Patients with Stroke Sequelae

What causes intracerebral bleeding after thrombolysis for acute ischaemic stroke? Recent insights into mechanisms and potential biomarkers

Fever Management Practices of Neuroscience Nurses

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