The effect of body temperature in the acute phase of subarachnoid hemorrhage on the long term outcome

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Background : In recent years, it has been disclosed experimentally and clinically that the brain temperature is one of the most important factors that decide the outcome of the brain disease. The purpose of this study is to evaluate the effect of the body temperature control in the acute phase of the subarachnoid hemorrage.Materials and Method : First, we developed a new SAH grading scale based solely upon the Glasgow Coma Scale and the standard outcome evaluated by Glasgow Outcome Scale with numerical translation (dead=1 to good recovery=5) for each grade. We investigated the relatioship between the SAH grade and the body temperature on the admission. Eight patients with SAH received temperature control therapy in the acute phase of the disease uwing cooling blanket to be kept at slightly hypothermic condition. The outcome was evaluated at 3 months after the onset.Results : A newly developed SAH grading is as follows ; I (GCS=15), II (GCS=11-14), III (GCS=8-10), IV (GCS=4-7), and V (GCS=3). Standard outcomes for each SAH grade are as follows respectively ; 4.68(]SY.+-。[)0.05,4.10(]SY.+-。[)0.06,3.55(]SY.+-。[)0.11,2.65(]SY.+-。[)0.10, and 1.81(]SY.+-。[)0.22. The outcome of the patients with temperature control did not exceed the standard outcome. The body temperature in the patients with low SAH grade was significantly lower than those with high SAH grade.Conclusion : These results suggest that the application of the hypothermia therapy to the patients with SAH must be done with great care in order to exceed the standard outcome.