If a post-operative craniotomy patient experiences a high temperature within the first 48 hours, what is this likely due to?

In the context of a post-operative craniotomy patient experiencing a high temperature within the first 48 hours, the most likely cause is linked to the increased intracranial pressure (ICP), particularly in relation to the hypothalamus. After surgery, the body undergoes various physiological changes, including an inflammatory response to trauma and manipulation of brain tissues. The hypothalamus plays a critical role in thermoregulation, and when it is affected—either directly due to surgical intervention or indirectly as a result of swelling or increased ICP—it may fail to correctly regulate body temperature.

In the immediate post-operative period, it is common for patients to have transient fevers due to the body’s natural inflammatory response to surgery. However, if the fever is persistent and the patient's neurological status is altered, it raises concern for increased ICP. This can lead to a malfunction in the hypothalamus's ability to control temperature, resulting in hyperthermia.

Surgical wound infections and systemic infections typically develop after the first 48 hours post-operatively and do not usually manifest immediately. While inflammation plays a role in temperature dysregulation, in the post-operative setting, it is essential to assess neurological status and consider ICP, especially with surgical procedures involving the brain.