title: Disassociation between intracranial and systemic temperatures as an early sign of brain death.
abstract: Intracranial temperature and its normal variation, as well as its response to various pathologic conditions, has become a critical component of monitoring in neurosurgical intensive care. In a prospective clinical study of 54 neurosurgical patients, intracranial pressure, cerebral perfusion pressure, and intraventricular and systemic temperatures were monitored in a neurosurgical intensive care unit. All of our patients' intraventricular temperatures were initially higher than their systemic temperatures. In 11 patients, the intraventricular temperature became lower than the systemic temperature, in a median time of 4.43 hours (range, 4.21-5.18 hours), prior to any changes in intracranial and cerebral perfusion pressures. Reversal of the disassociation between intraventricular and systemic temperatures may be an early marker of patients with a poor prognosis.
authors.affiliation: Department of Neurosurgery, The Medical Center of Central Georgia, Mercer University School of Medicine, Macon, Georgia, USA. knfountasmd@excite.com
authors.forename: K N
authors.initials: KN
authors.lastname: Fountas
authors.forename: E Z
authors.initials: EZ
authors.lastname: Kapsalaki
authors.forename: C H
authors.initials: CH
authors.lastname: Feltes
authors.forename: H F
authors.initials: HF
authors.lastname: Smisson
authors.forename: K W
authors.initials: KW
authors.lastname: Johnston
authors.forename: A
authors.initials: A
authors.lastname: Grigorian
authors.forename: J S
authors.initials: JS
authors.lastname: Robinson
mesh_terms: D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous; D001794:Blood Pressure / Q000502:physiology; D001831:Body Temperature / Q000502:physiology*; D001921:Brain / Q000502:physiology*; D001926:Brain Death / Q000175:diagnosis / Q000503:physiopathology*; D002552:Cerebral Ventricles / Q000502:physiology; D005260:Female; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011379:Prognosis; D015742:Propofol; D011446:Prospective Studies
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol