Hyperthermia Associated with Bilateral Mesencephalothalamic Infarction

Central hyperthermia is characterized by the rapid onset of high body temperature, marked temperature fluctuation, and high mortality. It is usually associated with brainstem damage caused by direct destruction or indirect compression. Herein, we report a 79-year-old man with bilateral paramedian mesencephalothalamic infarction presenting with hyperthermia. On admission, his body temperature was 39.3 degrees C aurically. Motor or sensorial deficit was not present. He was hospitalized at the infectious disease service. Upon the suspicious history and the absence of any infectious source on laboratory investigations, he was sent to our department on his first day of hospitalization. This case shows that upper paramedian mesencephalic and/or thalamic structures play a major role in the regulation of body temperature and that infarctions involved these structures could present with central hyperthermia. The history of this case also impresses the necessity of physicians' awareness about the central causes of hyperthermia, particularly in patients with the rapid onset of high temperature with marked fluctuation.