Cooling therapy for acute stroke.
BACKGROUND
Recent studies in acute stroke patients have shown an association between body temperature and prognosis.


OBJECTIVE
Our objective was to assess the effects of cooling when applied to patients with acute ischaemic stroke or primary intracerebral haemorrhage.


METHODS
We searched the Cochrane Stroke Group's trial register (last searched in March 1999), plus MEDLINE searched up to November 1998 and EMBASE searched from January 1980 to November 1998. We contacted investigators, pharmaceutical companies and manufacturers of cooling equipment in this field.


METHODS
All completed randomised controlled trials or controlled clinical trials, published or unpublished, where cooling therapy (therapy given by physical devices or antipyretic drugs primarily to lower body temperature independently of basal temperature at the beginning of treatment) was applied up to two weeks of an acute ischaemic stroke or primary intracerebral haemorrhage.


METHODS
Two reviewers independently searched for relevant trials.


RESULTS
No randomised trials or controlled trials were identified; one placebo-controlled trial of metamizol is currently underway.


CONCLUSIONS
There is currently no evidence from randomised trials to support the routine use of physical or chemical cooling therapy in acute stroke. Since experimental studies showed a neuroprotective effect of hypothermia in cerebral ischaemia, and hypothermia appears to improve the outcome in patients with severe closed head injury, trials with cooling therapy in acute stroke are warranted.
Correia
M
M
Neurology Department, Hospital Geral de Santo António, Largo Prof Abel Salazar, Porto, Portugal, 4050. nedcv@mail.telepac.pt
Silva
M
M
Veloso
M
M
D006801:Humans; D007036:Hypothermia, Induced; D020521:Stroke / Q000628:therapy*