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. 2020 Apr 21;94(16):e1738-e1748.
doi: 10.1212/WNL.0000000000009288. Epub 2020 Mar 27.

Antihyperthermic treatment decreases perihematomal hypodensity

Pablo Hervella  1 , Manuel Rodríguez-Yáñez  2 , José Manuel Pumar  2 , Paulo Ávila-Gómez  2 , Andrés da Silva-Candal  2 , Ignacio López-Loureiro  2 , Elena Rodríguez-Maqueda  2 , Clara Correa-Paz  2 , José Castillo  2 , Tomás Sobrino  2 , Francisco Campos  2 , Ramón Iglesias-Rey  1
Affiliations

Antihyperthermic treatment decreases perihematomal hypodensity

Pablo Hervella et al. Neurology. .

Abstract

Objective: To investigate the effect on perihematomal hypodensity and outcome of a decrease in body temperature in the first 24 hours in patients with intracerebral hemorrhage (ICH).

Methods: In this retrospective study on a prospectively registered database, among the 1,100 patients, 795 met all the inclusion criteria. Temperature variations in the first 24 hours and perihematomal hypodensity (PHHD) were recorded. Patients ≥37.5°C were treated with antihyperthermic drugs for at least 48 hours. The main objective was to determine the association among temperature variation, PHHD, and outcome at 3 months.

Results: The decrease in temperature in the first 24 hours increased the possibility of good outcome 11-fold. Temperature decrease, lower PHHD volume, and a good outcome were observed in 31.8% of the patients who received antihyperthermic treatment.

Conclusion: The administration of early antihyperthermic treatment in patients with spontaneous ICH with a basal axillary temperature ≥37.5°C resulted in good outcome in a third of the treated patients.

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Figures

Figure 1
Figure 1. Example of CT scan
CT scan obtained during the first week after admission. The perihematomal hypodensity volume is calculated by subtracting the hematoma volume (region inside the black dashes) from the total volume of the lesion (white dashes).
Figure 2
Figure 2. Temperature and modified Rankin Scale (mRS) score
Decrease in temperature during the first 24 hours in relation to the mRS score at 3 months ± 15 days. CI = confidence interval.
Figure 3
Figure 3. Perihematomal hypodensity (PHHD) and modified Rankin Scale (mRS) score
PHHD volume in each score of the mRS evaluated at 3 months ± 15 days. ANOVA = analysis of variance; CI = confidence interval.
Figure 4
Figure 4. Perihematomal hypodensity (PHHD) volume
Scatterplot of decrease in body temperature at 24 hours and the PHHD volume. The decrease in temperature is associated with a lower PHHD volume.
Figure 5
Figure 5. Therapeutic response
(A) Decrease in body temperature at 24 hours in the antihyperthermic treated group (without and with a therapeutic response) and the nontreated group. (B) Perihematomal hypodensity (PHHD) volume in the 3 groups according to the therapeutic response. CI = confidence interval.
See this image and copyright information in PMC

Comment in

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