This Article Full Text Full Text (PDF) All Versions of this Article: 35/9/2128    most recent 01.STR.0000137607.61697.77v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Audebert, H. J. Articles by Haberl, R. L. Search for Related Content PubMed PubMed Citation Articles by Audebert, H. J. Articles by Haberl, R. L. Related Collections Acute Cerebral Infarction Computerized tomography and Magnetic Resonance Imaging Pathology of Stroke Thrombolysis

(Stroke. 2004;35:2128.)
© 2004 American Heart Association, Inc.

Original Contributions

Systemic Inflammatory Response Depends on Initial Stroke Severity but Is Attenuated by Successful Thrombolysis

Heinrich J. Audebert, MD; Michaela M. Rott, MD; Thomas Eck, MD Roman L. Haberl, MD

From the Department of Neurology, Hospital Munich-Harlaching, Germany.

Correspondence to Dr H. Audebert, Abteilung für Neurologie, Städtisches Krankenhaus München-Harlaching, Sanatoriumsplatz 2, 81545 München-Harlaching, Germany. E-mail neuro.audebert{at}khmh.de

Background and Purpose— To determine whether body temperature, c-reactive protein (CRP), and white blood cell (WBC) count within the first days after stroke onset correlate with infarct size and stroke severity, and to examine whether successful thrombolysis reduces poststroke inflammation.

Methods— Out of 1500 consecutive acute ischemic stroke patients, 346 cases (43 patients with thrombolysis) were selected according to the following criteria: admission to hospital 24 hours after event, absence of prestroke and poststroke infectious disease, no intracerebral hemorrhage or brain stem stroke, and data availability. Body temperature, WBC within 3 days, and CRP within 5 days of event were determined daily. Lesion volume was measured by planimetry on computed tomography or MRI scans. Successful thrombolysis was defined as improvement on the National Institutes of Health Stroke Scale of 4 points within 24 hours.

Results— Increase of inflammatory parameters correlated significantly with lesion volume and stroke severity. This was shown for body temperature on days 2 and 3 (P<0.001), CRP on days 1 to 5 (P<0.05), and WBC on days 1 to 3 (P<0.01). Patients with successful thrombolysis had reduced body temperature on day 3, WBC on days 2 and 3, and CRP on days 3 to 5 (P<0.05).

Conclusions— Patients with a larger stroke volume and more severe stroke deficits have higher body temperature, CRP, and WBC count in the acute phase after stroke. Successful thrombolysis is related to a significantly attenuated inflammatory response.

Key Words: c-reactive protein • cerebral infarction • inflammation • leukocytes • stroke, acute • temperature • thrombolysis

This article has been cited by other articles:

				B. Hochsmann, R. Huber, P. Schauwecker, H. Schrezenmeier, M. Wiesneth, and A. Storch HEMISPHERIC STROKE DOES NOT MOBILIZE CD34+ HEMATOPOIETIC STEM CELLS INTO THE PERIPHERAL BLOOD Neurology, April 7, 2009; 72(14): 1277 - 1278. [Full Text] [PDF]

				T Molnar, A Peterfalvi, L Szereday, G Pusch, L Szapary, S Komoly, L Bogar, and Z Illes Deficient leucocyte antisedimentation is related to post-stroke infections and outcome J. Clin. Pathol., November 1, 2008; 61(11): 1209 - 1213. [Abstract] [Full Text] [PDF]

				B. H. Buck, D. S. Liebeskind, J. L. Saver, O. Y. Bang, S. W. Yun, S. Starkman, L. K. Ali, D. Kim, J. P. Villablanca, N. Salamon, et al. Early Neutrophilia Is Associated With Volume of Ischemic Tissue in Acute Stroke Stroke, February 1, 2008; 39(2): 355 - 360. [Abstract] [Full Text] [PDF]

				S. Laowattana and S. M. Oppenheimer Protective effects of beta-blockers in cerebrovascular disease Neurology, February 13, 2007; 68(7): 509 - 514. [Abstract] [Full Text] [PDF]

				N. Nighoghossian, M. Wiart, S. Cakmak, Y. Berthezene, L. Derex, T.-H. Cho, C. Nemoz, F. Chapuis, G.-L. Tisserand, J.-B. Pialat, et al. Inflammatory Response After Ischemic Stroke: A USPIO-Enhanced MRI Study in Patients Stroke, February 1, 2007; 38(2): 303 - 307. [Abstract] [Full Text] [PDF]

				A. Chamorro, J.P. Horcajada, V. Obach, M. Vargas, M. Revilla, F. Torres, A. Cervera, A.M. Planas, and J. Mensa The Early Systemic Prophylaxis of Infection After Stroke Study: A Randomized Clinical Trial Stroke, July 1, 2005; 36(7): 1495 - 1500. [Abstract] [Full Text] [PDF]

				M. Di Napoli, M. Schwaninger, R. Cappelli, E. Ceccarelli, G. Di Gianfilippo, C. Donati, H. C.A. Emsley, S. Forconi, S. J. Hopkins, L. Masotti, et al. Evaluation of C-Reactive Protein Measurement for Assessing the Risk and Prognosis in Ischemic Stroke: A Statement for Health Care Professionals From the CRP Pooling Project Members Stroke, June 1, 2005; 36(6): 1316 - 1329. [Abstract] [Full Text] [PDF]

				K. Sander, D. Sander, H. Audebert, and R. L. Haberl Systemic Inflammatory Response Depends on Initial Stroke Severity but Is Attenuated by Successful Thrombolysis * Response Stroke, February 1, 2005; 36(2): 232 - 232. [Full Text] [PDF]

				H. C.A. Emsley, C. J. Smith, R. F. Georgiou, A. Vail, P. J. Tyrrell, E. M. Barberan, N. J. Rothwell, S. J. Hopkins, H. Audebert, and R. L. Haberl Correlation of Systemic Inflammatory Response With Infarct Volume in Acute Ischemic Stroke Patients * Response Stroke, February 1, 2005; 36(2): 228 - 229. [Full Text] [PDF]