Disassociation between intracranial and systemic temperatures as an early sign of brain death.
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.
Fountas
K N
KN
Department of Neurosurgery, The Medical Center of Central Georgia, Mercer University School of Medicine, Macon, Georgia, USA. knfountasmd@excite.com
Kapsalaki
E Z
EZ
Feltes
C H
CH
Smisson
H F
HF
Johnston
K W
KW
Grigorian
A
A
Robinson
J S
JS
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
D018686:Anesthetics, Intravenous; D015742:Propofol