title: Therapeutic hypothermia in acute ischemic stroke.
abstract: Increased body temperatures are common in the acute phase of stroke. Experimental and clinical studies have suggested that increased body temperatures are related to poor outcome. In animal studies of focal cerebral ischemia, early hypothermia consistently reduced infarct volume. Based on these findings, several Phase II clinical trials have been performed to study physical methods to reduce body temperature in patients with acute stroke. The feasibility and safety of these methods have not yet been established with sufficient certainty. Pharmacological lowering of body temperature may be an attractive alternative approach. In guidelines for the treatment of acute stroke, antipyretics are generally recommended to reduce fever, although their effect on functional outcome is unknown. There is currently no evidence from randomized trials to support routine use of physical or pharmacological cooling in acute stroke. Large randomized clinical trials are needed to study the effect of both physical and medical cooling on functional outcome after stroke.
authors.affiliation: Deparment of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. m.denhertog@erasmusmc.nl
authors.forename: Heleen
authors.initials: H
authors.lastname: den Hertog
authors.forename: Bart
authors.initials: B
authors.lastname: van der Worp
authors.forename: Maarten
authors.initials: M
authors.lastname: van Gemert
authors.forename: Diederik
authors.initials: D
authors.lastname: Dippel
mesh_terms: D000818:Animals; D001831:Body Temperature; D001930:Brain Injuries / Q000628:therapy; D002545:Brain Ischemia / Q000150:complications*; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*