Mellergård P, Nordström C H
Department of Neurosurgery, University Hospital of Lund, Sweden.
Br J Neurosurg. 1990;4(1):31-8. doi: 10.3109/02688699009000679.
Although it has been known for a long time that pronounced hypothermia has a protective effect on the brain during ischemia, and that severe hyperthermia damages neuronal tissue, knowledge of human brain temperature is very limited. The recent findings by two independent research groups, that even small differences in brain temperature significantly influence the degree of neuronal damage following cerebral ischemia, became the incentive for measuring brain temperature in neurosurgical patients. The temperature of the lateral ventricle, epidural space, membrana tympani and rectum were measured with copper-constantan thermocouples. During the implantation of an intraventricular catheter for measuring intracranial pressure, a temperature gradient of 0.4-1.0 degrees C between the lateral ventricle and the epidural space was noted. Continuous measurements for 1-5 days showed that the rectal temperature usually adequately reflects the temperature of the epidural space, although the temperature of the membrana tympani followed changes in epidural temperature more closely. However, at times, and in one patient during most of the time, the temperature of the epidural space was up to 1 degree C above rectal temperature. The relevance of these findings for the care of neurosurgical patients is discussed in relationship to what is known about brain temperature from animal experiments.
尽管人们早就知道，明显的低温在缺血期间对大脑有保护作用，而严重的高温会损害神经元组织，但关于人脑温度的了解却非常有限。两个独立研究小组最近的发现，即即使脑温的微小差异也会显著影响脑缺血后神经元损伤的程度，这成为了测量神经外科患者脑温的诱因。使用铜-康铜热电偶测量侧脑室、硬膜外间隙、鼓膜和直肠的温度。在植入用于测量颅内压的脑室内导管期间，注意到侧脑室和硬膜外间隙之间存在0.4-1.0摄氏度的温度梯度。持续1-5天的测量表明，直肠温度通常能充分反映硬膜外间隙的温度，尽管鼓膜温度更紧密地跟随硬膜外温度的变化。然而，有时，在一名患者的大部分时间里，硬膜外间隙的温度比直肠温度高出1摄氏度。结合动物实验中关于脑温的已知情况，讨论了这些发现对神经外科患者护理的相关性。
