[Moderate hypothermia for the treatment of malignant middle cerebral artery infarct].
Moderate hypothermia was induced in 30 patients with malignant middle cerebral artery (MCA) territory infarction. Patients were kept at 33 degrees C body-core temperature for 48 to 72 h, and ICP, CPP, and brain temperature were monitored. Outcome at 4 weeks and at 3 months after the stroke as well as side effects of moderate hypothermia were analysed. Mortality of malignant MCA infarction could be reduced from 80% in historical controls, to 43% (13/30) under hypothermia. During hypothermia elevated ICP values could be significantly reduced. Herniation due to a secondary rise of ICP after rewarming was the cause of death in all 13 patients. The most frequent complication of moderate hypothermia was pneumonia in 12 of the 30 patients (40%). Other severe side effects of hypothermia could not be detected. Moderate hypothermia may improve clinical outcome in patients with malignant MCA infarction.
Neurologische Klinik, Universität Heidelberg.
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Schwab
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Schwarz
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Bertram
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Spranger
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Hacke
D000293:Adolescent; D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000628:therapy*; D002544:Cerebral Infarction / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome
Moderate Hypothermie zur Behandlung des malignen Mediainfarktes.