Asymmetrical Skin Temperature in Ischemic Stroke

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Abstract
Background and Purpose Sympathetic dysfunction is known to manifest commonly in stroke as cardiovascular and sudomotor dysregulation, but the knowledge so far obtained concerning skin temperature and vasomotor changes in cerebrovascular diseases is contradictory. The purpose of the present study was to evaluate cutaneous temperature in ischemic stroke in a prospective follow-up study. Methods Skin temperature was measured at five sites on each side of the body at rest and after a heating stimulus in 44 patients with a hemispheric infarction, and in 19 patients with a brain stem infarction, in the acute phase and at 1 month and at 6 months after the infarction. Results Skin temperatures on the forearm, leg, and foot on the side contralateral to the site of infarction were significantly lower than on the ipsilateral side during the whole 6-month follow-up period. Asymmetrical temperature was associated with the presence of pyramidal tract signs in hemispheric infarction and with the presence of Wallenberg’s syndrome in brain stem infarction. In hemispheric infarction, the degree of asymmetrical temperature correlated with the severity of limb paresis. Conclusions A temperature decline in the limbs contralateral to the site of infarction seems to be a frequent, long-lasting consequence of autonomic failure in patients with stroke. The phenomenon seems to be associated with pyramidal tract signs and the presence of Wallenberg’s syndrome.