Defective thermoregulation after traumatic brain injury. A single subject evaluation.
Central fever is a known complication of traumatic brain injury (TBI), particularly in association with brain stem involvement. Chronic deficits in thermoregulation after TBI have not been reported. We describe a patient who had central fevers acutely after injury, but developed intermittent temperature elevations during thermal stress in the post-acute phase. A prospective evaluation of the patient's temperature control was conducted. The patient stayed in the laboratory for two half-day evaluation sessions. On the first day, the room temperature was raised by 10 degrees F each hour and rectal temperature was recorded hourly. On the second day, the room temperature was lowered by 10 degrees each hour in a similar fashion. The patient's core temperature rose above normal in the warm environment but did not drop in the cold environment. This suggests that the patient had a chronic deficit in either sensing temperature elevations or activating heat dissipation mechanisms under thermal stress.
Greenery Rehabilitation Center, Boston Massachusetts.
J
J
Whyte
D T
DT
Filion
T R
TR
Rose
D000293:Adolescent; D001833:Body Temperature Regulation / Q000502:physiology*; D001933:Brain Stem / Q000293:injuries* / Q000503:physiopathology; D005334:Fever / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology; D008297:Male; D009104:Multiple Trauma / Q000503:physiopathology; D011446:Prospective Studies; D012008:Recurrence