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Research has clearly established that elevated temperature worsens the outcome of ischemic stroke (Stroke 1998; 29:529). In patients with acute stroke, the relative risk for poor outcome doubles with every degree of acute body temperature elevation (Lancet 1996; 347:422).
In this multicenter trial, researchers enrolled 1400 patients with acute ischemic or hemorrhagic stroke and tympanic or rectal temperature of 36°C to 39°C (mean, 36.9°C). The median baseline NIH Stroke Scale score was 6 to 7 (range, 0 to 30). Within 12 hours of stroke onset, subjects were randomized to treatment with either acetaminophen (AC; 6 g/day for 3 days) or placebo. The primary outcome was defined as improvement “beyond expectation” on the modified Rankin scale at 3…