Following a brain injury, individuals may find themselves feeling too hot or too cold, sometimes transitioning between the two. This is often due to damage to the hypothalamus, a gland in the brain that regulates body temperature and other functions to maintain homeostasis. When the hypothalamus is compromised, a person may lose the ability to control or stabilise their body temperature.
In the following article Sian Francis, Case Manager and Registered Nurse at Empowering U, looks at temperature regulation following a brain injury. With over 14 years’ experience in diverse healthcare settings, including ICU (intensive care units), A&E (accident & emergency), surgical, medical, and community care, Sian shares her findings below.
Sian notes “Although the following article shares proven techniques for monitoring temperature, there are no regulations in place at the current time, and the following should be used as a general guideline.”
Sian is pursuing this to ensure appropriate care is considered which has a standardised approach with all hospitals.
Sian Francis
How is Temperature Regulation following a Brain Injury Affected?
So how does a traumatic brain injury (TBI), stroke, or another type of acquired brain injury (ABI) impact temperature regulation? It largely depends on the extent and severity of the damage to the hypothalamus. To understand this, it’s crucial to know how the body maintains temperature.
The food and drinks we consume provide energy to the body. This energy is metabolised in our cells to produce heat and maintain a regular body temperature, a process controlled by the hypothalamus.
Normal body temperature typically ranges from 36.4°C to 37.2°C. Brain temperature is specifically influenced by local heat production, blood vessel temperature, and cerebral blood flow. When the hypothalamus is damaged following a TBI, its ability to regulate body temperature and cerebral blood flow can be compromised. This is critical because inadequate cerebral blood flow deprives the brain of the optimal levels of oxygen and nutrients required for effective functioning and recovery.
Additionally, the somatosensory cortex, which processes sensory information including touch, temperature, and pain, contributes to the experience of temperature. When the hypothalamus or somatosensory cortex is affected by a brain injury, there can be more pronounced fluctuations in body and brain temperature.
Recognising Irregular Body Temperature After a Brain Injury
In individuals unaffected by a brain injury, the hypothalamus automatically releases hormones to regulate body temperature. This causes blood vessels to constrict, directing heat to core organs and maintaining a normal temperature. For individuals affected by a brain injury, this function is impaired, leading them to feel cold even when the ambient temperature is warm.
In severe cases of brain injury, this can lead to hypothermia or hyperthermia.
Hypothermia is caused by an extreme drop in body temperature, occurring below 35°C. Individuals with hypothermia may experience:
- Shivering
- Pale, cold and dry skin
- Slurred speech
- Slow breathing
- Fatigue or confusion
Hyperthermia is caused by an extreme increase in body temperature, occurring above 40°C. Individuals with hyperthermia may experience:
- Abnormal heartbeat
- Rapid breathing
- Low blood pressure
- Nausea
- Excessive thirst
- Headaches
Proven Techniques for Monitoring Temperature Following Injury
To regulate temperature can be a significant concern for individuals recovering from brain injuries, leading to further challenges with a change of weather conditions. Suggestions that follow help to manage as well as monitor temperature fluctuations effectively at home or at any point during rehabilitation:
The use of digital thermometers provides accurate and quick readings. Ear and forehead thermometers are useful for their ease of use. Consider smart thermometers that sync with apps to track temperature trends over time.
Smart thermostats and environmental sensors help maintain a stable indoor temperature and monitor humidity levels, providing a comfortable and safe environment.
Smartwatches and fitness trackers with temperature monitoring features can be invaluable. Temperature patches that continuously monitor body temperature and send data to a smartphone is also a good option.
Schedule regular checks throughout the day, especially during alternating weather conditions. Be vigilant for physical signs of temperature dysregulation, such as sweating, shivering, or changes in skin colour.
Maintain a stable indoor climate with air conditioning and heating systems. Use humidifiers or dehumidifiers to control humidity levels, which can affect body temperature regulation.
Hydration is key to temperature regulation. Ensure adequate fluid intake and adjust clothing layers according to indoor and outdoor temperatures.
Regular consultations with healthcare providers can also help tailor these strategies to meet individual needs, ensuring a well-rounded approach to rehabilitation.
Have an emergency plan in place, including a list of contacts for immediate assistance and a first aid kit with essentials like ice packs and warm blankets.
Comprehensive Care: Ensuring Optimal Support for Brain Injury Survivors
Understanding and managing temperature regulation following a brain injury is crucial for the well-being and recovery of individuals. Our case managers play a vital role in this process, providing support and guidance to those living with a brain injury.
Our expert team, comprising registered nurses, occupational therapists, and physiotherapists, employs effective monitoring techniques and strategies to help mitigate the risks associated with temperature dysregulation.
