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Background and purpose  The deleterious effect of hyperthermia on intracerebral hemorrhage ( ICH ) has been studied. However, the results are not conclusive and new studies are needed to elucidate clinical factors that influence the poor outcome. The aim of this study was to identify the clinical factors (including  ICH  etiology) that influence the poor outcome associated with hyperthermia and  ICH . We also tried to identify potential mechanisms involved in hyperthermia during  ICH .    Methods  We conducted a retrospective study enrolling patients with non‐traumatic  ICH  from a prospective registry. We used logistic regression models to analyze the influence of hyperthermia in relation to different inflammatory and endothelial dysfunction markers, hematoma growth and edema volume in hypertensive and non‐hypertensive patients with  ICH .    Results  We included 887 patients with  ICH  (433 hypertensive, 50 amyloid, 117 by anticoagulants and 287 with other causes). Patients with hypertensive  ICH  showed the highest body temperature (37.5 ± 0.8°C) as well as the maximum increase in temperature (0.9 ± 0.1°C) within the first 24 h. Patients with  ICH  of hypertensive etiologic origin, who presented hyperthermia, showed a 5.3‐fold higher risk of a poor outcome at 3 months. We found a positive relationship ( r  = 0.717,  P  < 0.0001) between edema volume and hyperthermia during the first 24 h but only in patients with  ICH  of hypertensive etiologic origin. This relationship seems to be mediated by inflammatory markers.    Conclusion  Our data suggest that hyperthermia, together with inflammation and edema, is associated with poor outcome only in  ICH  of hypertensive etiology.

Inflammation, edema and poor outcome are associated with hyperthermia in hypertensive intracerebral hemorrhages