Summary
24 patients, 16 after severe head injury and 8 after spontaneous intracranial haematoma, were investigated by external cold load in order to determine their thermoregulatory capabilities.
Tympanic temperature, several skin temperatures and oxygen consumption were measured. The patients where examined for SSEP and AEP. The cold induced thermoregulatory threshold temperature was determined by calculating the mean body temperature and by determining mean body temperature at which oxygen consumption increased due to the external cold load.
In all patients core temperature and mean body temperature were significantly elevated by 1 °C compared to controls. There was no difference of the course of the various body temperatures during cold load in the patient groups. In the trauma group 8 patients were able to increase oxygen use (VO2) during cold exposure, the other 8 patients showed no physiological thermoregulatory reaction. The heatproduction threshold temperature was increased by 1 °C in the patient groups compared to controls. There was no significant correlation of AEP and SSEP findings to a preserved or disturbed thermoregulatory reaction. In the trauma patients, who were able to respond to a cold load, the outcome was significantly better (GOS=3–5), than in those patients, who did not show a physiological increase of VO2 due to the cold load (GOS=1–2).
In conclusion, measurement of body temperatures alone is not sufficient to determine termoregulatory capacities. An examination using thermophysiological methods however provides more information about the function and structure damaged after severe head injury. An intact thermoregulatory systems seems to be correlated with a better prognosis after head injury.
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Behr R, Dietrich C, Brück K, Roosen K (1991) Human temperature regulation altered by intracranial space occupying lesions. In: Yoshikawa M, Uono M, Tanabe H, Ishikawa S (eds) New trends in autonomic nervous system research. Basic and clinical integration. Excerpta Medica: 106–109
Behr R, Hildebrandt G, Koca M, Brück K (1991) Modifications of thermoregulatory characteristics in patients with suprasellar pituitary adenoms. Brain 114/II: 697–708
Behr R, Dietrich C, Hildebrandt G, Klug N, Brück K (1991) Thermoregulation in patients with skull base tumors. In: Samii M (ed) Surgery of the sellar region and paranasal sinuses. Springer, Wien New York, pp 395–406
Bligh J (1973) Temperature regulation in mammals and other vertebrates. In: Frontiers of biology, Vol 30. North-Holland, Amsterdam, pp 303–321
Boulant JA, Hardy JD (1972) Hypothalamic and medullary neuronal responses to deep-body, peripheral and local temperatures. Int J Biometer 16 [Suppl] Biometeorology 5: 38–39
Brück K, Baum E, Schwennick HP (1976) Cold-adaptive modifications in man induced by repeated short-term cold exposures and during a 10-day and -night cold-exposure. Pflügers Arch 363: 125–133
Brück K (1987) Basic mechanisms in long time thermal adaptation. Pergamon-Press, Oxford In: Szelenyi Z, Szekely M (eds) Advances in physiological sciences, Vol 32. Contribut Thermal Physiol 263–273
Brück K, Zeisberger E (1987) Adaptive changes in thermoregulation and their neuropharmacological basis. Pharmac Ther 35: 163–215
Brück K, Zeisberger E (1990) Adaptive changes in thermoregulation and their neuropharmacological basis. In: Schönbaum E, Lomax P (eds) Thermoregulation physiology and biochemistry. International encyclopedia of pharmacology and therapeutics, pp 255–307
Brück K, Hinckel P (1990) Thermoafferent networks and their adaptive modifications. In: Schönbaum E, Lomax P (eds) Thermoregulation physiology and biochemistry. International encyclopedia of pharmacology and therapeutics. Pergamon, Elmsford, NY, pp 129–152
Dawson TJ (1972) Primitive mammals and patterns in the evolution of thermoregulation. In: Bligh J, Moore RE (eds) Essays on Temp Reg, pp 1–18
Greenberg RP, Mayer DJ, Becker DP, Miller ID (1977) Evaluation of brain function in severe human head trauma with multimodality evoked potentials. J Neurosurg 47: 150–162
Greenberg RP, Newton PG, Hyatt MS, Narayan RK, Becker DP (1981) Prognostic implications of early multimodality evoked potentials in severely head-injured patients. J Neurosurg 55: 227–263
Hensel H (1981) Thermoreception and temperature regulation. academic Press, London. Monographs of the Physiological Society 38
Hessemer V, Brück K (1985) Influence of menstrual cycle on shivering, skin blood flow and sweating responses measured at night. J Appl Physiol 59: 1902–1910
Hessemer V, Zeh A, Brück K (1986) Effects of passive heat adaptation and moderate sweatless conditioning on responses to cold and heat. Eur J Appl Physiol 55: 281–289
Jessen C (1967) Auslösung von Hecheln durch isolierte Wärmung des Rückenmarks am wachen Hund. Pflügers Arch 297: 53–70
Lausberg G (1972) Zentrale Störungen der Temperatureregulation. Acta Neurochir (Wien) [Suppl] 19
Nakayama T, Hardy JD (1969) Unit responses in the rabbit's brain stem to changes in brain and cutaneous temperature. J Appl Physiol 27: 848–857
Ramanathan NL (1964) A new weighting system for mean surface temperatures of the human body. J Appl Physiol 19: 531–533
Simon E, Rautenberg W, Thauer R, Iriki M (1963) Auslösung thermoregulatorischer Reaktionen durch lokale Kühlung im Vertebralkanal. Naturwissenschaften 50: 337
Simon E, Rautenberg W, Thauer R, Iriki M (1964) Die Auslösung von Kältezittern durch lokale Kühlung im Wirbelkanal. Pflügers Arch 281: 309–331
Simon E, Rautenberg W, Jessen C (1965) Initiation of shivering in unanesthetized dogs by local cooling within the vertebral canal. Basel. Experientia 21: 476–477
Watanabe T, Morimoto A, Murakami N (1986) Effect of amine on temperature-responsive neurons in slice preparation of rat brain stem. Am J Physiol 250: 553–559
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Dedicated to Prof. Dr. K. Brück, Former Head of the Institute of Physiology of the University of Giessen, Federal Republic of Germany.
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Behr, R., Ehrlinspiel, D. & Christophis, P. Temperature regulation as possible prognostic indicator in patients with acute intracranial lesions. Acta neurochir 138, 192–199 (1996). https://doi.org/10.1007/BF01411360
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DOI: https://doi.org/10.1007/BF01411360