title: Delayed hypothermia in malignant ischaemic stroke.
abstract: Moderate hypothermia may reduce mortality in malignant brain infarction. However, due to the extremely limited number of patients treated, it is still unknown whether it may be beneficial if undertaken several days after acute stroke, when the probability of a malignant oedema is higher. We report on a patient with malignant brain oedema after middle cerebral artery infarction, who was treated with moderate hypothermia on the third day after stroke when he became comatose. Hypothermia was induced at a rate of 1.25°C/h by an intravascular cooling catheter. The target temperature of 32°C was reached in about 6 h. After 36 h of hypothermia, the patient was actively re-warmed at a rate of 0.2°C/h. The patient survived and showed a progressive reduction of mass effect on CT scan. This single case study suggests a beneficial effect of hypothermia in the treatment of severe space-occupying ischemic infarction even on the third day after stroke onset.
authors: Institute of Neurology, Università Cattolica, L.go A. Gemelli 8, 00168, Rome, Italy. vdilazzaro@rm.unicatt.it
authors: Vincenzo
authors: V
authors: Di Lazzaro
authors: Paolo
authors: P
authors: Profice
authors: Michele
authors: M
authors: Dileone
authors: Giacomo
authors: G
authors: Della Marca
authors: Cesare
authors: C
authors: Colosimo
authors: Emanuele
authors: E
authors: Pravatà
authors: Antonino
authors: A
authors: Pavone
authors: Mariano
authors: M
authors: Pennisi
authors: Riccardo
authors: R
authors: Maviglia
authors: Fabio
authors: F
authors: Pilato
mesh_terms: D020520:Brain Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020244:Infarction, Middle Cerebral Artery / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed