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The field of neurology is focused increasingly on treatments. Nowhere is this more evident than in the area of neurologic intensive care. In this issue of Neurology, Mayer et al.1 report their assessment of one potential therapy—control of fever.
Research on modulation of temperature has consistently shown that hyperthermia worsens, and hypothermia ameliorates, neurologic injury in experimental stroke and head injury.2,3⇓ Lowering brain temperature may reduce injury by suppressing excitotoxins and oxygen radicals, stabilizing cell membranes, and reducing the number of abnormal electrical depolarizations.4 In humans, outcome after ischemic stroke is worse in patients who are febrile.5,6⇓ Preliminary studies of induced hypothermia in patients with large strokes or head injury7 and in patients who are undergoing surgery to repair cerebral aneurysms8 have suggested benefit; however, an …
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