Neurogenik Fever

There was an increased risk of development of NF among patients with severe TBI who had experienced either diffuse axonal injury (DAI) or frontal lobe injury of any form.
Other risk factors predicting early hyperthermia include Glasgow Coma Scale score in the emergency department ≤ 8, paediatric trauma score ≤ 8, cerebral oedema or DAI on initial head computed tomography, admission blood glucose > 150mg/dL ,    white cell count   > 14,300cells/mm3, and systolic hypotension

PATHOPHYSIOLOGY

• Cerebral temperature has been recognised as a strong factor in ischaemic brain damage. Fever is extremely frequent after acute cerebral damage, and cerebral temperature is significantly higher than body core temperature. Body core temperature may markedly underestimate cerebral temperature, especially during the phases when temperature has the greatest impact on the central nervous system (CNS).  
• NF results from a disruption in the hypothalamic set point temperature, which results in an abnormal increase in body temperature, and is thought to be caused by injury to the hypothalamus.

MANAGEMENT

1. External cooling methods until the diagnosis is made and appropriate drug therapy. 
2. Many drugs which have successfully been used either anecdotally, or in case reports, to treat NF, include: bromocriptine, amantadine, dantrolene, and propranolol. As each of these drugs has significant  potential side effects (for example, hypotension and    gastrointestinal     bleeding)