Acute violation cerebral circulation is an extremely dangerous condition that requires immediate treatment, especially if a fever occurs during a stroke. After a stroke, people often remain disabled, especially if assistance was provided untimely or unqualified. Currently, the development of new methods of treatment and recovery after stroke continues.

Types of stroke

This indicates the high social significance of this problem for our country. Specialists pay no less attention to studying the causes of cerebrovascular accidents. The stroke itself can occur in different ways, and accordingly, the consequences for a person can be very diverse. It is worth noting that a stroke does not always immediately put a person to bed, and the lack of timely treatment makes its further course more difficult.

It is not recommended to use independent or traditional methods for treatment or subsequent recovery after a stroke - they can complement therapy, but only as an adjunct, and if prescribed by a doctor.

Surgical assistance for stroke is a guarantee of the patient’s life

The main symptoms of acute cerebrovascular accident include the following:

• headache, often strong;
• dizziness;
• neurological symptoms that appear immediately after the stroke occurs
• increase in body temperature of varying intensity.

Early signs of stroke

If an experienced doctor is diagnosing a stroke, then body temperature must be monitored, which almost always increases after an acute disorder. In the future, this indicator often becomes a means of monitoring the patient’s condition. Of course, thermometry is far from the only diagnostic method, but if the temperature rises to critical values, most often this indicates extensive hemorrhage in the brain tissue.

If we are talking about an ischemic stroke that develops without hemorrhage, a constantly elevated temperature may indicate pathologies such as:

• cerebral edema;
• an inflammatory process in the body caused by bacteria or viruses;
• thrombosis of arteries or veins;
• pneumonia or exacerbation of chronic diseases.

Temperature during a stroke is an important diagnostic criterion, which cannot be ignored.

What temperature readings can be considered normal for a stroke?

Ischemic stroke is often characterized by low-grade fever

Since cerebral circulatory disorders are a serious problem for humans, there is no question that the temperature should remain within the well-known normal limits (36.6). This is due to the release of prostaglandins into the blood, which are formed in huge quantities during any inflammation. Therefore, with any acute cerebrovascular accident, a rise in temperature to 37.2-37.5 degrees Celsius can be observed. This is typical for the first days of the crisis.

But if the thermometer inexorably shows more high values, this almost always indicates a significant deterioration of the condition, or the addition of complications. The prognosis for the patient in this case worsens. If emergency and adequate measures are not taken for such patients, the patient’s life may be at risk.

Why is hyperthermia dangerous during a stroke?

Hyperthermic syndrome is dangerous for any person, not to mention patients with strokes. Any increase in temperature leads to a sharp acceleration of all metabolic processes in the body. In acute cerebrovascular accident, hyperthermia increases the permeability of the blood-brain barrier, enzyme activity decreases, and brain cell death occurs faster.

Carrying out thermometry

If there are too many dead cells, the focus of the stroke increases with irreversible changes in the central nervous system, after which the person may become disabled. It is worth noting that the active death of brain cells due to circulatory disorders has already begun, so control of body temperature is very important during treatment. Hyperthermia is especially dangerous in hemorrhagic lesions of brain tissue.

Thermometry in patients with strokes should be carried out at least 2 times a day, even with a visible improvement in the condition. This is due to the inability of such a patient to adequately assess their condition - they may simply not notice the high temperature.

Diagnosis of hyperthermia

An increase in a patient's body temperature after a stroke can occur for a number of other reasons. In the first place are purulent-inflammatory diseases (PIDs), which could be present in a person before the stroke. To eliminate errors in diagnosing the cause of hyperthermia, it is assessed according to many criteria, for example:

• maximum temperature values;
• cyclicality;
• effectiveness of antipyretic therapy.

In addition, the dynamics of temperature increases are also taken into account, depending on the presence or absence of foci of intravenous insufficiency or complications. For differential diagnosis, thermometry is carried out up to 8 times a day.

How to help a person with hyperthermia?

It is worth noting that treatment of stroke at home is not possible - hospitalization is mandatory. However, it is useful to know that regardless of the cause of the stroke itself, the patient is often left alone in the room. If there are signs of fever, on the advice of a doctor, you can only take non-steroidal anti-inflammatory drugs (analgin, ibuprofen).

In case of hemorrhagic stroke in a hospital setting, other methods of combating hyperthermia can be used, after which the patient’s condition improves. They use narcotic, non-steroidal anti-inflammatory and sedative drugs.

Non-drug methods

Non-invasive

Cooling occurs exclusively through the skin. Ice packs, wet bandages, or special helmets placed on the patient's head can be used - coolant constantly circulates inside the helmet.

Invasive

1. For this purpose, intravenous infusion of cooled saline solution is used. The method is convenient because it allows you not only to quickly cool a person, but also to warm you up if the need arises.
2. Intravenous catheter temperature management. The essence of the method is to install a special catheter that has its own cooling system. A temperature sensor is installed in the patient's urinary catheter, based on the readings of which the temperature of the intravenous catheter changes. This is a rather complex, but highly effective system that allows you to constantly monitor and adjust the patient’s temperature.

A situation often arises when, during an attack or some time after it, the patient feels heat and aches throughout the body. The temperature during a stroke can indicate how much damage the brain was during the hemorrhage, and what processes are currently occurring in the body. These indicators can help specialists competently build treatment tactics so that the patient gets better as soon as possible.

So, why and to what values ​​can the temperature rise after a cerebral hemorrhage, and how can you help the patient in this case?

When a stroke is suspected, doctors always pay close attention to how high the patient's temperature becomes. These indicators help to find out exactly what processes are occurring in the body at the moment. Depending on how high the temperature rises during a stroke, the following conditions can be expected to develop in the body.

At values ​​not higher than 37.5 degrees the situation is normal, the patient’s health is not in danger. In this case, pathological processes that can significantly worsen the patient’s condition and cause death do not begin to occur in the body. The optimal temperature at which there is no cause for concern is 37.2.

A temperature of 36 degrees is characteristic of an ischemic stroke. If this indicator lasts for a long time, then this is a good indicator. No destructive processes occur in the body and the patient can count on a favorable outcome.

When the temperature during a stroke rapidly rises above 37.5 degrees, this means that destructive processes have begun in the body, which can negatively affect the outcome of the disease and lead not only to numerous complications, but also to death.

There is a direct relationship between an increase in temperature and a rapid deterioration in the patient’s condition, since at this moment the hematoma rapidly increases in size and begins to put pressure on the brain, disrupting metabolic processes and causing its deformation. In this case, we are not talking about normal recovery of the body; it becomes almost impossible for the patient to avoid death. An increase in body temperature during a stroke, even by 1 degree, can be critical.

Another extremely negative point is when during an attack the patient’s condition does not cause concern, and destructive processes begin to increase later. In this case, a high temperature after a stroke becomes a signal that the patient’s chances of survival are rapidly decreasing.

Therefore, timely administration of antipyretic drugs to patients will be of vital importance. This will help normalize body temperature, and doctors will not have a large number of time to stabilize the condition of the injured person. Therefore, if a cerebral hemorrhage or a microstroke is suspected, the patient is immediately given antipyretic and blood-thinning drugs.

Hyperthermia during a stroke can occur for the following reasons. When a hemorrhage occurs in the brain stem. This area is responsible for thermoregulation; if it is damaged, a sharp increase in body temperature is possible. In some cases, the occurrence of this condition is facilitated by the resorption of damaged cells.

Activation of pathogenic organisms in the body under the influence of stroke. Brain edema and thrombosis, which slow down blood flow, which contributes to an increase in intoxication in cells. Exacerbation of diseases such as pneumonia, infections of the genitourinary system and pathologies of the cardiovascular system.

Allergy to medications. When the temperature rises after a stroke, this reason is the most favorable, since the patient’s chances of survival remain quite high. It is only important to replace unsuitable medications in a timely manner.

Knowing about these negative factors, doctors try to carefully monitor the condition of patients and promptly take the necessary measures to prevent hyperthermia. The consequences of such a condition can be dire.

With a sharp increase in body temperature, the following processes begin to increase in the body:

• Intercellular metabolism is significantly enhanced, which negatively affects brain cells that experience severe oxygen starvation. Symptoms of intoxication also begin to increase.
• Tissue necrosis gradually increases, the affected area increases.
• The gray matter receives damage, under the influence of which it begins to change and gradually die. All this leads to the death of brain cells, which increases the risk of death.

If the patient manages to survive, there is a high risk that he will be unable to care for himself for the rest of his life. In severe cases, patients often fall into a coma.

Situations often arise when the temperature after a stroke begins to rise about a month after the cerebral hemorrhage. This phenomenon may have the following reasons. The presence of infection in the body. After a stroke, the body is weakened, and pathogenic organisms begin to spread quickly, causing the occurrence of diseases of various etiologies.

Poor care for a bedridden patient when he begins to develop a large number of bedsores. When the patient has been diagnosed with a tracheoscoma and is not properly cared for. Poor quality treatment of catheters and their installation sites. The consequences of such a negligent attitude can be disastrous, even leading to sepsis..

An increase in congestion in the body, when the patient simply lies in bed without moving. In such cases, it becomes very vulnerable to any viruses and bacteria. Standard diseases are much more severe in such cases. The occurrence of pneumonia.

In this case, patients may suffer from increased sweating, but their health will be within normal limits; patients do not experience severe pain syndromes, only severe and prolonged weakness.

How to help a patient

To reduce the risk of fever, you should not only follow all the instructions of your doctor, but also do the following: Carefully, especially if he is lying down. Carry out hygienic treatment regularly, change bed and underwear.

If a person lies without getting up, change body position regularly to avoid the occurrence of non-healing bedsores. You can also use specially designed mattresses for this purpose, which are suitable both for hospital use and for home use.

If you have catheters or drainage tubes, their care should be especially careful. You should regularly treat the skin around them, periodically remove the devices themselves and replace them with new ones. Avoid contact of the patient with potential carriers of infection so as not to provoke the occurrence of diseases.

When a patient has a fever, he should be given a regular antipyretic. Antibiotics are prohibited. Regularly carry out wet cleaning in the room where the patient is located and provide ventilation at least once a day. should contain a sufficient amount of vitamins and microelements to help a weakened body get into shape as quickly as possible.

Any type of self-medication is strictly prohibited, as uncontrolled use medicines may provide Negative influence on the patient's condition. Before giving a fever-reducing medication, it is important to make sure that the person can swallow it on their own. Otherwise, it makes sense to give him syrup or suspension.

If the patient's condition begins to rapidly deteriorate, he should be taken to a medical facility as soon as possible. Doctors will carry out all necessary treatment measures to stabilize the patient’s condition.

Temperature during and after a stroke is an ominous signal indicating the presence of pathological processes in the body. To prevent their rapid development and avoid deterioration of the patient’s condition, it is necessary for him to take an antipyretic drug as early as possible. In this case, it will be possible to slow down or completely get rid of a bacterial or viral infection, and avoid the development of pathological processes in the brain. All this will not only help normalize the patient’s condition, but will also help avoid the development of many complications.

A brain crash is sometimes accompanied by a reaction that some consider atypical. The temperature often does not exceed normal values, and its significant increase serves as an additional diagnostic symptom.

Mechanisms of temperature increase during stroke

The hypothalamus and its special zone are involved in the regulation of body temperature. Neurons operate in a certain mode and set a “set point” that regulates the processes of heat transfer and heat production. A change in their work occurs under the influence of pyrogens: exo- or endogenous substances that can increase temperature.

They can act directly on nerve cells or indirectly through other substances. Viruses and bacteria act as pyrogens coming from outside. Endogenous are represented by various substances after cell breakdown.

Stages of temperature increase:

1. Under the influence of pyrogens, interleukin-1 is produced in leukocytes.
2. The effect of IL-1 on the hypothalamic thermoregulation center.
3. Restructuring the work of the center and increasing the temperature.

In this case, a spasm of blood vessels in the skin and smooth muscles occurs, and heat transfer decreases. A signal about cold weather is sent to the brain, the tone of skeletal muscles increases, trembling develops, and heat production increases.

An increase in temperature during a stroke may be caused by direct damage to the cells of the hypothalamus. Disruption of blood flow in it due to hemorrhage or vasospasm leads to a temperature reaction. This mechanism is called central.

Valid values

If a stroke occurs, the temperature may be slightly reduced to 36.0 degrees. This is explained by decreased blood flow and is a favorable diagnostic criterion. Hyperthermia up to 37.5 degrees is considered acceptable. A temperature of 38 or higher during a stroke indicates extensive hemorrhage and the development of necrotic processes. The higher this indicator, the worse the prognosis for the patient.

As fever develops, oxidative reactions accelerate and tissue oxygen demand increases. Reflexively, for every additional degree the heartbeat increases by 10 beats. Breathing also increases.

Reasons for rising temperature

Etiology of hyperthermia in different periods stroke is different. Common reasons temperature during stroke:

• extensive hemorrhage;
• ischemia of a large area of ​​the brain;
• thrombosis of arteries or veins;
• necrosis of brain tissue;

Involvement of the thermoregulation center in the stroke area leads to neurogenic hyperthermia. Sometimes an allergy to some medications used can cause a high temperature during a stroke, which is an indication for discontinuing the medication used and using a drug from a different group.

According to various studies, a significant number of patients experienced hyperthermia within a month after suffering a cerebral accident. The causes of temperature after a stroke are as follows:

• pneumonia;
• formation of bedsores in paralyzed people;
• inadequate care for bedridden patients;
• use of tracheostomy;
• congestion during prolonged lying down;
• exacerbation of chronic infectious diseases, often genitourinary infections;
• after – tissue necrosis.

Heat after a stroke is accompanied by increased sweating, lack of feeling unwell and complaints of pain.

Consequences of rising temperatures

Hyperthermia does not go away without leaving a trace. It promotes enlargement of the lesion and cell death. In other tissues, oxidative reactions intensify and the need for oxygen increases. Inadequate blood supply leads to hypoxic injury. Long-term consequences - various post-stroke pathologies, worsening rehabilitation prognosis, coma, death.

Ways to eliminate hyperthermia

High temperature during a stroke does not always decrease after taking antipyretic anti-inflammatory drugs. This is explained by the mechanism of action of the drug; it is based on suppressing the synthesis of substances that promote the production of IL-1. In case of cerebral hemorrhage or ischemia, the increase in temperature has a central mechanism. Leukocytes can be activated and produce interleukin in the event of necrotic processes.

In a hospital setting, lytic mixtures - solutions for intravenous administration - are used to eliminate fever. Even saline solution administered by drip reduces fever due to its lower temperature relative to the blood.

At home, while the ambulance is traveling, you need to remove the warm clothes, do not cover. You can wipe the areas where large vessels adhere to the skin with cool water. This is the neck area, elbow bends, popliteal fossae.

Fever after a stroke is often caused by infection. Therefore, for treatment, the doctor may prescribe non-steroidal anti-inflammatory drugs (Paracetamol, Indamethacin). Antibiotic treatment should be prescribed by a doctor after examination.

Preventing fever

The formation of bedsores after hemorrhage can be prevented by frequently turning the paralyzed patient over. It is optimal to use a special anti-decubitus mattress. Turning over in bed prevents congestion and pneumonia. You can use massage. If pneumonia has already developed, this will facilitate the separation of sputum.

The installed tracheostomy is checked daily for patency and cleaned. Sterile catheters are used for irrigation. The skin around it is wiped with furacillin and lubricated with zinc paste. It is important to maintain body hygiene and washing. The ward or room where the patient is located after a stroke must be ventilated daily and wet cleaning carried out.

You can learn about the main symptoms of a stroke from the video:

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Temperature during a stroke plays an important role in determining the severity of the pathological process. This indicator helps to detect hemorrhage and prevent swelling of brain tissue in time. Hyperthermia and increased blood pressure appear as compensatory reactions of the body to the development of ischemia. The speed of blood movement in the vessels increases in order to deliver oxygen and nutrients to the neurons, but in the event of an acute disorder of cerebral circulation, such a protective reaction can only worsen the general condition.

Normal indicators

Body temperature indicators reflect the state of the body during a stroke attack. Clinical studies revealed the following pattern: the higher the temperature, the higher the risk of hemorrhage. The temperature after an ischemic stroke is slightly lowered, but within normal limits. Indicators can drop to +36°C, which is due to changes in blood circulation in the body. With this mark, the chances of a quick recovery without the development of complications increase. The critical limit of normal is considered to be +37.5°C.

Many people are interested in what the temperature is during a hemorrhagic stroke, which is characterized by rupture of a cerebral artery followed by hemorrhage in the brain. Hyperthermia, in which the thermometer mark rises above the permissible limit of +37.5 ° C, indicates severe damage to the central nervous system. In such a situation, with increasing indicators, the likelihood of complications, coma and death increases.

An increase in temperature can lead to necrosis, inflammation, new thrombus formation and recurrent cerebrovascular accident.

How often do you get your blood tested?

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Only as prescribed by the attending physician 30%, 949 votes

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21.10.2019

Why does the temperature rise

If the temperature rises after a stroke, the cause of the symptom development indicates the development of complications. With hyperthermia, the following are possible: extensive hemorrhage in the brain, an atypical anaphylactic or allergic reaction to drug therapy, damage to an infectious or viral disease. The most dangerous etiology of an increase in temperature is considered to be thrombosis of the cerebral arteries, cerebral edema and rupture of a cerebral vessel with subsequent hemorrhage.

Depending on the cause of hyperthermia, the patient is prescribed medication:

• if swelling of the brain tissue is suspected, diuretics are prescribed;
• development of infectious inflammatory processes inhibited by antibacterial drugs.

In the post-stroke period, high temperature accelerates intracellular metabolism in response to progressive cerebral ischemia. The body tries to restore nutrition to neurons by increasing the heart rate. As a result, the speed of blood flow increases and the temperature begins to rise. But in conditions of acute disturbance of cerebral circulation, the tissues are not saturated with nutrients and oxygen, and hypoxia develops.

In the absence of treatment, against the background of a rise in temperature, tissue necrosis develops, inflammation spreads, and the area of ​​ischemia continues to expand. Hyperthermia worsens the condition, causing complications and coma.

During clinical studies, doctors recorded that in severe strokes, the temperature rose 4-6 hours after the stroke. With moderate pathology, the time period increased to 10-12 hours and reached +38...+40°C. Against the background of microstrokes or ischemic strokes not accompanied by rupture of the vessel, the temperature does not rise.

Complications that threaten a person's life can develop soon after the onset of a stroke.

Life-threatening complications include, among other things, the patient’s high temperature.

A fever after a stroke may be a sign of infection, such as pneumonia or a urinary tract infection.

Prevention of these complications is one of the main areas of initial stroke treatment.

The appearance of inflammatory processes and elevated body temperature in the acute phase of ischemic stroke is a well-known phenomenon.

Elevated body temperature may occur in cases of infection by exogenous microorganisms or an endogenous inflammatory response to the repair of brain tissue.

The human body's response to the invasion of inflammatory microorganisms, such as bacteria, triggers a process that activates leukocytes and prostaglandins, changing the thermoregulatory setting in the anterior hypothalamus of the brain.

The resulting response from the sympathetic nervous system (part of the autonomic nervous system) raises the core temperature of the brain to feverish levels. As a result, the patient's overall body temperature rises to fight the foreign agent.

Fever is most common during the first two days after a stroke. However, its true cause is not always easy to establish. Some research suggests that the timing of a fever may indicate its origin.

Normal fever due to stroke-related disease begins within 24 hours of stroke symptoms, while fever due to infection occurs at a later time.

This suggests that if early infection is excluded, early fever in stroke patients may indicate a neurological origin.

It has been suggested that in patients with small stroke infarct volumes, a marked increase in body temperature, C-reactive protein, or white blood cell levels should be taken as an indicator of infection.

Patients with large infarcts also often have a mild increase in temperature in the absence of infection.

When quantifying the inflammatory markers C-reactive protein, fibrinogen and leukocytes, it was found that ischemic stroke does not cause the typical acute phase reaction associated with high temperature in most patients.

However, in severe strokes, massive tissue necrosis can increase body temperature. Another cause of non-infectious fever may be the presence of blood in the brain.

As a result, studies have found that in most cases the identified cause of fever after a stroke is infection.

Temperature readings after a brain stroke

A study of patients hospitalized after ischemic stroke shows that 25% of patients have a body temperature greater than 38C within 24 hours of stroke onset.

32% had a temperature above 37.5C ​​within 48 hours of stroke onset.

It is suggested that probable reasons elevated temperature within 48 hours after an ischemic stroke include the presence in the body of patients of pneumococci, streptococci, Escherichia coli, enterococci, parainfluenza virus or influenza virus type A.

The researchers conclude that most cases of fever (about 83%) can be explained by infectious or chemical aspiration pneumonia.

Pneumonitis (localized tissue damage in the lungs) is often accompanied by early bacterial infection, even within the first 48 hours after a stroke.

After a stroke, the patient must follow a diet. Nutrition after an ischemic stroke excludes the consumption of fatty, salty and some other foods. Read more about proper nutrition.

How to overcome it?

1. Temperature management is considered an important component of stroke care.
2. To reduce fever, Acetaminophen (Paracetamol) is recommended, with dosages adjusted for specific cases. Approximate dosages of Acetaminophen are 325-1000 mg every 4-6 hours up to 6 times a day (but not more than 4 g/day) at temperatures above 38.6C. If the body temperature is high, antipyretics (antipyretics) are recommended, both for ischemic and hemorrhagic strokes

. The temperature threshold and treatment strategy in this case are selected individually.

Treatment of elevated body temperature during a stroke is recommended only in its acute period.

It is emphasized that there is currently no evidence that lowering body temperature in febrile or afebrile patients improves neurological outcome.

Treatment with antipyretic drugs when a stroke occurs should be considered very carefully, since reducing the fever may prolong the course of the infection in the patient.

Prophylactic administration of antipyretics may also mask infections and delay antibiotic treatment when they are indicated for the patient.

A noticeable decrease in temperature can provoke physical cooling, trembling and narrowing of the lumen of blood vessels.

The clinical benefits of lowering body temperature in the treatment of stroke patients have not yet been established.