Central hyperthermia

context

  • acute stroke

why bother?

associated with ↑ mortality
2o injury from ↑ metab rate
Distinguishing between central vs infective causes might allow us to avoid unnecessary antibiotics use - resistance, side effects...

pathophysiology

  • hypothalamus no worky
  • secondary cause - pituitary no worky?

ddx

  • of course ICU patients are prone to all sorts of weird and wonderful infections - consider ventilator-associated pneumonia, line infection, surgical site infection along with the usual
  • some weird non-infective causes:
    • paroxysmal sympathetic hyperactivity

perhaps we should suspect it more in:

  • relative bradycardia

management

  • it's all pretty evidence-light
  • case studies suggest
    • bromocriptine
    • baclofen

#incomplete

More #icu weirdness

Brain injury
Neuroprotection in critical illness

Fever in the ICU patient

https://jbnc.com.br/artigo/the-meaning-of-fever-in-traumatic-brain-injury/1680 J Bras Neurocirur 35 (4):337-353, 2024 - Systemic review
J Neurocrit Care 2020;13(1):19-31
https://derangedphysiology.com/main/required-reading/neurological-intensive-care/Chapter-612/fever-neurosurgical-patients