Temperature-lowering therapy for acute stroke

Body temperatures above 37.5°C have been observed in 4% to 25% of patients within the first 24 to 36 hours after stroke onset and are associated with poor long-term outcome. In the observational Copenhagen Stroke study, a 1°C increase in body temperature measured within 12 hours after stroke onset doubled the odds of poor outcome.
In animal models of focal cerebral ischemia, cooling reduces infarct volume. Hypothermia is successfully used in cardiac surgery and has been associated with a more favorable neurological outcome in patients who were resuscitated after cardiac arrest.
These observations suggest that reduction of body temperature and prevention of fever may improve functional outcome after stroke. However, the potentially beneficial effects of temperature-lowering therapy might be offset by side effects such as infections, cardiac arrhythmias, hemorrhagic transformation of infarcts, and deep venous thrombosis.
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