Fever in neurological disease

Fever common in many types of neurologically illnesses, including acute ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage and brain trauma.

Fever found in 75% of patients with critical neurological illness.

Fever independently worsens neurological outcome and increases mortality in such patients.

Patients with intracranial bleeding may have central Fever, unrelated to infection.

Inappropriate antibiotics for fever not relsted to infection can have adverse effects and increase bacterial resistance.

Fever was seen in a retrospective study in 46.8% with a central cause (Hocker SE).

Infectious disease fever more common in older patients with longer stays in the ICU, in the above study.

Central fever more likely to occur within 72 hours of admission to neurological ICU.

Negative CXR, cultures, presence of subarachnoid hemorrhage, intraventricular hemorrhage , tumor, and onset of fever within 72 hours predicted central Fever with a 90% probability.

Pharmacological and nonpharmacological methods are required to treat fever and include: surface cooling blankets and body conformed wraps,intravascular cooling devices, cooling caps, inhaled cooling systems with fluorocarbons, and pharmocologic agents.

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