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April 13, 1940

CEREBRAL SYMPTOMS IN FEVER THERAPYWITH ESPECIAL REFERENCE TO CEREBRAL HYDRODYNAMICS AND PRESSURE-VOLUME RELATIONSHIPS: A STUDY OF FOUR CASES

JAMA. 1940;114(15):1437-1439. doi:10.1001/jama.1940.02810150023007
Abstract

Certain definite physical and hydrodynamic alterations take place intracranially during fever therapy and demand immediate recognition by the clinician or technician in charge. Certain dangers incident to treatment can thus be avoided, the patient made more comfortable and the management of certain diseases made more efficacious by proper treatment.

It is important to recognize early symptoms and signs of cerebral anoxia and edema which are produced during the course of artificial fever therapy. The recognition of certain characteristic manifestations of cerebral hyperemia is equally important. By properly timed spinal drainage, the intracerebral pressure and volume relationships can be maintained at a normal level and the dangerous phases of cerebral anemia and hyperemia can be prevented. It is a well recognized fact that serious and permanent brain damage may occur when either state prevails.

During the course of hyperpyrexia several salient physiologic changes are recognized.1 In the induction phase there

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