摘要
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-brain) and core-temperature (T-core) relative to the occurrence of SDs. Twenty consecutive comatose ICH patients with multimodal electrocorticograpy (ECoG) and T-brain 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-core and T-brain was 37.3 degrees C (36.9-37.8) and 37.4 degrees C (36.7-37.9), respectively. T-brain but not T-core significantly increased 25 min preceding the onset of SDs by 0.2 degrees C (0.1-0.2; p < 0.001) and returned to baseline 35 min following SDs. During clusters, T-brain increased to a higher level (+0.4 degrees C [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-brain >= 38.0 degrees C (23% probability), than during T-brain <= 36.6 degrees C (9% probability). Spreading depolarizations - and in particular clusters of SDs - may increase brain temperature following ICH.
- 出版日期2018-3