Fever

• From Skin to Sinus: A Rare Case of Cerebral Venous Sinus Thrombosis Caused by Occipital Subcutaneous Abscess
• A Rare Presentation of Ruptured Pineal Region Teratoma with Postoperative Aseptic Meningitis
• Fever in the Neurocritically Ill Patient
• Experience with surgical evacuation of neonatal brain abscess: A patient series and review of literature
• Childhood penetrating intracranial injury by non-metallic objects: a case report of three pediatric cases
• Low-Grade Glioma in the Differential Diagnosis of Limbic Encephalitis
• Neuromelioidosis outbreak in Tamil Nadu, India: an investigation of transmission with genomic insights
• Intracranial tuberculoma as an immune reconstitution inflammatory syndrome in a man with AIDS, tuberculous meningitis, and diffuse large B-cell lymphoma

Prolonged fever is the common complication in neurosurgical patients. The risks of prolonged fever in patients are attributed to antibiotic therapy, use of central venous catheter and prolonged mechanical ventilation. Indicators of prolonged fever are helpful for better identification of high-risk patients and fever control ¹⁾.

Fever Etiology

Oral acetaminophen continues to be the primary choice for fever management, followed by ice packs and fans. This study encourages the development of a stepwise approach to neuro-specific protocols for fever management. Furthermore, it shows the continuing need to promote further education and specialty training among nurses and encourage collaboration with physicians to establish best practices ²⁾.

Fever burden is associated with early neurological deterioration in intracerebral hemorrhage patients undergoing hematoma evacuation. The findings add to previous evidence on the relationship between the fever burden and the occurrence of early neurological deterioration in patients with intracerebral hemorrhage. Future studies with larger sample sizes are required to confirm these findings ³⁾.

In a review Kitagawa et al. from McGovern Medical School at the University of Texas Health Science Center at Houston published in Neurosurgical Clinics of North America to review fever etiology in neurocritically ill patients, assessed current pharmacologic and mechanical strategies for temperature control, and evaluated the existing evidence on whether these interventions improve clinical outcomes. The goal was to inform clinical decision-making in the neuro ICU setting. They concuded that fever is common in neuro ICU patients and is associated with worse outcomes. While several interventions effectively reduce body temperature, the literature remains inconclusive regarding their impact on prognosis. Management should be individualized, weighing the potential benefits against adverse effects. Further research is needed to clarify the clinical value of temperature control in this population ⁴⁾

Another polished yet pointless review, safely orbiting the surface of a real clinical problem without offering a single actionable insight. If you’ve spent time in a Neuro-ICU, you already know everything this article says. And if you haven’t — reading it won’t help you survive your next febrile crisis.

Reads like a literature summary assembled for a PowerPoint — not a review meant to rethink practice.

1. No Original Insight:

The authors elegantly describe what we already know: fever is bad, its causes are multiple, and cooling may help… or not. The “inconclusive evidence” card is played like a wildcard that justifies intellectual passivity.

2. Methodological Vacuum:

No structured methodology for selecting studies. No inclusion criteria. No rating of evidence quality. It’s a narrative review in the loosest sense — more “cut and paste” than “critique and synthesize.”

3. Absence of Controversy:

No discussion of ongoing debates: Should we induce hypothermia in subarachnoid hemorrhage? Is neurogenic fever overdiagnosed? Are cooling devices overused in resource-limited settings? Silence.

4. Zero Framework for Decision-Making:

The article ends exactly where it starts: “We don’t really know, so be cautious.” It neither proposes a clinical algorithm nor offers stratification by patient subtype. It fails the very clinicians it claims to inform.

This review exemplifies the academic theater of modern neurosurgery:

Appearing rigorous by stacking references,

Avoiding any position that could provoke discussion,

Leaving the reader grateful for the reminder — and utterly unchallenged.

A safe publication to decorate a CV — not to change a protocol.

Challenged the dogma of treating all fever aggressively.

Differentiated infectious from neurogenic fever with diagnostic criteria.

Evaluated temperature control methods with outcome-focused critique.

Proposed a management algorithm or research agenda.

Instead, it chose the intellectual equivalent of lukewarm water — ironic for a paper on body temperature.

Clinical value: Low Scientific contribution: Minimal Risk of drowsiness: High

You can read it. You just won’t remember it. And that’s the problem.

Among 2845 patients, prolonged fever occurred in 466 (16%). The older patients were associated with longer duration of mechanical ventilation and length of stay. It was predominantly occurred in patients with subarachnoid hemorrhage (SAH) and traumatic brain injury. Patients receiving antibiotic treatment tended to manifest prolonged fever more frequently. Multivariate analysis revealed that the use of antibiotics, central venous catheter and prolonged mechanical ventilation were independent risk predictors for prolonged fever. Patients diagnosed with brain tumor seemed to be not associated with prolonged fever.

Prolonged fever is the common complication in neurosurgical patients. The risks of prolonged fever in patients are attributed to antibiotic therapy, use of central venous catheter, and prolonged mechanical ventilation. Indicators of prolonged fever are helpful for better identification of high-risk patients and fever control. ⁵⁾.