Published online before print September 13, 2007, doi: 10.1161/STROKEAHA.107.488197
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(Stroke. 2007;38:e132.)
© 2007 American Heart Association, Inc.
Letters to the Editor |
Response to Letter by den Hertog et al
Department of Neuroscience, University of California San Diego, San Diego, Calif
Response:
We appreciate the importance of avoiding increased body temperature after stroke as treatment of fever reduced poor neurological outcome after stroke.1 We thank Dr den Hertog et al for pointing out that more evidence is needed to investigate the feasibility and efficacy of the various available cooling methods after stroke. We are currently testing the safety and feasibility of induced hypothermia and thrombolysis with tissue plasminogen activator until 6 hours after stroke.2
The proof of neuroprotective efficacy after cardiac arrest has spurred an increased interest in neuroprotection through hypothermia after stroke and we greatly welcome this.3,4 Most likely the neuroprotective effect is highest when treatment is initiated early, and we agree with the comments that delayed treatment is unlikely to yield success.
Acknowledgments
Disclosures
None.
References
1. Kammersgaard LP, Jorgensen HS, Rungby JA, Reith J, Nakayama H, Weber UJ, Houth J, Olsen TS. Admission body temperature predicts long-term mortality after acute stroke: The Copenhagen Stroke study. Stroke. 2002; 33: 1759–1762.
2. Guluma KZ, Hemmen TM, Olsen SE, Rapp KS, Lyden PD. A trial of therapeutic hypothermia via endovascular approach in awake patients with acute ischemic stroke: methodology. Acad Emerg Med. 2006; 13: 820–827.[CrossRef][Medline] [Order article via Infotrieve]
3. The Hypothermia After Cardiac Arrest Study. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002; 346: 549–556.
4. Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. 2002; 346: 557–563.
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