Body Temperature Modulates Infarction Growth following Endovascular Reperfusion

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Fig 1.
CT perfusion mismatch maps for infarct core and penumbral volume estimates. Representative sample of the CT perfusion analysis pipeline with estimated infarction core (A) determined as relative cerebral blood flow <30% of normal and total hypoperfused tissue volume (B) measured from regions of time-to-maximum of residue function of >6 seconds. Lesion estimates (white overlays) produced from sequential sections obtained from presentation CT perfusion in a 62-year-old woman presenting with acute left MCA syndrome. Segmented lesions are overlaid on raw perfusion images for review purposes, and automated lesion volumes are produced as shown. Penumbral mismatch is computed from the difference between estimated lesion volumes and is summed for each of 2 contiguous perfusion slabs.

Table 1:

Patient characteristics and temperature profile^{^a}

Characteristics
Mean age (yr)	65 (range, 18–94)
NIHSS score	18 (14–22)
Women	60 (46.5%)
Presentation core infarction volume^{^b}	9.6 mL (1.5–25.3)
Hypoperfused volume^{^c}	132.6 mL (84.2–204)
Occluded vessels	n (%)
Intracranial ICA	17 (13.2%)
Extracranial ICA	2 (1.6%)
M1 MCA	63 (48.8%)
M2 MCA	24 (18.6%)
ACA	4 (3.1%)
Vertebrobasilar	1 (0.8%)
Tandem	18 (14%)
Reperfusion score
mTICI 2b	67 (52.9%)
mTICI 3	62 (48.1%)
Last known well to reperfusion	414 min (295–572)
CTP to reperfusion	119 min (84–162)
Procedure time to reperfusion	58.0 min (38.5–94.5)
Total procedural duration	77 min (51–118)
CTP-to-MRI time	26.8 hr (20–47.2)
Last known well to MRI	30.6 hr (24.0–51.2)
General anesthesia (No.)	44 (34.1%)
Aspirin therapy (No.)	125 (96.9%)
Received acetaminophen (No.)	91 (70.5%)
Final infarct volume	19.6 mL (8.3–45.2 mL)
Mean 90-day mRS	2
Favorable clinical outcome (mRS ≤2) (No.)	77 (59.7%)
90-day mortality (No.)	11 (8.5%)
Population temperature minima (mean)	35.3°C
Population temperature maxima (mean)	37.9°C
Per-patient temperature fluctuation	2.4°C (1.8°C–3.3°C)
Temperature increase from baseline	1.6°C (1.0°C–2.5°C)