[A study of skin surface temperature in patients with unilateral cerebral infarction--with special reference to central autonomic regulation of skin vasomotor response].

Skin surface temperature was examined using thermography in 26 patients with unilateral ischemic cerebrovascular disease (5 with pontine lesions, 5 with lateral medullary lesions and 16 with hemispheric lesions). Three of the 5 patients with pontine lesions and 4 of the 5 with medullary lesions showed hemihyperthermia on the ipsilateral body surface. However, the face showed no impairment with pontine lesions, whereas it appeared as a hyperthermic area with medullary lesions. Ten of 11 patients with lesions of the internal capsule or putamen had hypothermia on the contralateral body surface except for the face. All the patients with thalamic lesions showed no skin temperature asymmetry. These observations suggest the following: (1) sympathetic skin vasomotor fibers descend through the ipsilateral side of the brainstem; (2) at the level of the medulla, skin vasomotor fibers innervating the body trunk and limbs and those innervating the face descend contiguously, while at the level of the pons the two fiber groups descend separately; (3) hypothermia in patients with cerebral infarction could be explained by interruption of the inhibitory neural pathway that controls vasomotor function on the contralateral side of the body; (4) these inhibitory pathways descend in the vicinity of the pyramidal tract.