Cerebral pathophysiology and clinical neurology of hyperthermia in humans.

摘要: Deliberate hyperthermia has been used clinically as experimental therapy for neoplastic and infectious diseases. Several case fatalities have occurred with this form of treatment, but most were attributable to systemic complications rather than central nervous system toxicity. Nonetheless, demyelating peripheral neuropathy neurological symptoms nausea, delirium, apathy, stupor, coma reported. Temperatures exceeding 40 degrees C cause transient vasoparalysis in humans, resulting cerebral metabolic uncoupling loss pressure-flow autoregulation. These findings may be related the development brain edema, intracerebral hemorrhage, intracranial hypertension observed after prolonged therapeutic hyperthermia. Furthermore, deliberate critically worsens extent histopathological damage animal models traumatic, ischemic, hypoxic injury. However, it is unknown whether these translate episodes spontaneous fever neurologically injured patients. In a clinical setting strong prognostic marker patient's primary degree neuronal damage, causal relation long-term functional outcome not established types neurosurgical intensive-care unit extremely common whereas antipyretic only poorly effective. Therefore maintaining strict normothermia an impossible goal many Although there are several physiological arguments avoiding exogenous patients, no evidence that aggressive attempts at controlling can improve outcome.