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(Stroke. 2001;32:1697.)
© 2001 American Heart Association, Inc.

Letters to the Editor

Re: Stroke Severity Determines Body Temperature in Acute Stroke

J.C. Sharma, FRCP

Stroke Unit, Kings Mill Centre, Sutton in Ashfield, Nottinghamshire, UK

To the Editor:

Boysen and Christensen, in a recent Stroke article,¹ have introduced another dimension to the relationship of body temperature following a stroke and its influence on outcome. Only 5% of their patients had an elevated temperature on admission, which grew later to 12% in patients with major strokes. More significantly, the patients with major stroke had lower temperatures on admission, and this phenomenon was associated with higher mortality. One explanation for the rise in temperature in major strokes after admission is the aspiration pneumonia due to impaired swallowing, and the explanation for their higher mortality is also likely to be dysphagia,² although, regrettably, this relationship has not been reported in their paper. The authors very justifiably recommend a randomized trial of hypothermic therapy in acute strokes, although antipyretic use has been advocated³ despite the lack of evidence of its beneficial effect.

References

1. Boysen G, Christensen H. Stroke severity determines body temperature in acute stroke. Stroke. 2001;32:413–417.[Abstract/Free Full Text]

2. Sharma JC, Fletcher S, Vassallo M, Ross IN. What influences outcome of stroke: pyrexia or dysphagia? Int J Clin Pract. 2001;55:17–20.[Medline] [Order article via Infotrieve]

3. De Keyser J. Antipyretics in acute ischaemic stroke. Lancet. 1998;352:6–7.[Medline] [Order article via Infotrieve]

Response

Gudrun Boysen, MD Hanne Christensen, MD

Department of Neurology, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark

We thank Dr Sharma for his comment on our article. He suggests that the rise in temperature in the acute stroke patients was due to aspiration. We cannot rule out this possibility entirely. The rise in temperature, however, occurred within 6 to 8 hours after stroke onset in patients who were on intravenous fluids and rarely received anything by mouth.

We would expect a rise in temperature due to aspiration to occur later after stroke onset. We therefore assume that the rise in temperature was due to the brain lesion itself.