Table 1 Inclusion/exclusion criteria

○ Ischaemic or haemorrhagic stroke

○ Severe cardiac insufficiency (NYHA ≥ III)

○ ICP/temperature brain probe

○ Acute myocardial infarction or pulmonary embolism

○ Indication for therapeutic cooling independent of the study

○ Threatened ventricular dysrhythmia or cardiac dysrhythmia (heart rate <50/min, QTc >450 ms, sick sinus syndrome, AV block II-III°)

○ Sedation, intubation, and mechanical ventilation

○ Chronic sinusitis or current or past fracture or surgery of the paranasal sinuses not allowing secure application of nasopharyngeal cooling

○ Age ≥18 years

○ Severe infection with bacteraemia or sepsis ≥72 h

○ Written informed consent by patient or legal representative

○ Fever >38.5°C

○ Severe renal or liver insufficiency

○ Known haematologic disease with increased risk of thrombosis (e.g., cryoglobulinaemia, cold agglutinins or sickle cell anaemia)

○ Known vasospastic vascular disorder (e.g., Raynaud phenomenon or thromboangiitis obliterans)

○ Body weight >120 kg