How to manage fever in the neurocritical care unit in patients with acute stroke was clearly a question in need of an answer. The association of fever burden with poor outcome for diverse conditions in the neurocritical care unit has been well described. However, distinguishing association from causation has been difficult, with prior randomized trials of hypothermia in various neurologic injuries showing neither clear benefit nor harm. Additionally, while it might seem nuanced to those unfamiliar with this field, fever control requires an entirely different approach from interventions to achieve hypothermia. Guidelines are available to support the logistics of providing this therapy and the neurocritical care community who manage these patients have gained expertise in temperature control over the past 20 years, while testing targeted temperature management in a wide variety of neurologic injuries, including cardiac arrest, traumatic brain injury, severe stroke, and spinal cord injury.

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