{"title":"Acute Abnormalities Identified on Brain Magnetic Resonance Imaging in Patients with Sepsis.","authors":"Toru Hosokawa, Kosaku Kinoshita, Shingo Ihara, Katsuhiro Nakagawa, Umefumi Iguchi, Tomokazu Mutoh, Nami Sawada, Tsukasa Kuwana, Junko Yamaguchi, Atsushi Sakurai","doi":"10.1007/s12028-025-02235-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sepsis often codevelops with brain damage, and the mechanisms underlying sepsis-related brain damage have been elucidated. However, only a few studies have reported the diagnostic imaging assessments for brain damage in sepsis. Therefore, in this study, we analyzed the brain magnetic resonance (MR) imaging (MRI) findings of patients with sepsis.</p><p><strong>Methods: </strong>This single-center prospective observational study included 71 patients with sepsis who underwent brain MRI, regardless of the presence or absence of shocks and acute neurological abnormalities. The MR images were classified according to the presence or absence of acute cerebral ischemia and leukoencephalopathy, with normal findings indicating neither condition.</p><p><strong>Results: </strong>The MR images of 18 patients (25.3%) showed acute cerebral ischemia and leukoencephalopathy. Furthermore, 44 patients (62.0%) had only leukoencephalopathy. In terms of patient demographic characteristics and neurological outcomes, significant differences were noted among patients with acute cerebral ischemia findings, those with leukoencephalopathy findings, and those with neither. There were significant differences in age (P = 0.0296), neurological findings (P = 0.0057), number of days in the intensive care unit (P = 0.0239), acute disseminated intravascular coagulation score during hospitalization (P = 0.0363), and the Katz index at discharge or transfer (P = 0.0020) among these groups.</p><p><strong>Conclusions: </strong>Among patients with sepsis, 25.3% showed acute cerebral ischemia findings on brain MRI, regardless of illness severity, including hypoxia and hypotension, and presence of shock. Abnormal MRI findings were also observed in patients without acute brain dysfunction. Importantly, abnormal brain MRI findings were associated with worse neurological outcomes.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"437-445"},"PeriodicalIF":3.6000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurocritical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12028-025-02235-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Sepsis often codevelops with brain damage, and the mechanisms underlying sepsis-related brain damage have been elucidated. However, only a few studies have reported the diagnostic imaging assessments for brain damage in sepsis. Therefore, in this study, we analyzed the brain magnetic resonance (MR) imaging (MRI) findings of patients with sepsis.
Methods: This single-center prospective observational study included 71 patients with sepsis who underwent brain MRI, regardless of the presence or absence of shocks and acute neurological abnormalities. The MR images were classified according to the presence or absence of acute cerebral ischemia and leukoencephalopathy, with normal findings indicating neither condition.
Results: The MR images of 18 patients (25.3%) showed acute cerebral ischemia and leukoencephalopathy. Furthermore, 44 patients (62.0%) had only leukoencephalopathy. In terms of patient demographic characteristics and neurological outcomes, significant differences were noted among patients with acute cerebral ischemia findings, those with leukoencephalopathy findings, and those with neither. There were significant differences in age (P = 0.0296), neurological findings (P = 0.0057), number of days in the intensive care unit (P = 0.0239), acute disseminated intravascular coagulation score during hospitalization (P = 0.0363), and the Katz index at discharge or transfer (P = 0.0020) among these groups.
Conclusions: Among patients with sepsis, 25.3% showed acute cerebral ischemia findings on brain MRI, regardless of illness severity, including hypoxia and hypotension, and presence of shock. Abnormal MRI findings were also observed in patients without acute brain dysfunction. Importantly, abnormal brain MRI findings were associated with worse neurological outcomes.
期刊介绍:
Neurocritical Care is a peer reviewed scientific publication whose major goal is to disseminate new knowledge on all aspects of acute neurological care. It is directed towards neurosurgeons, neuro-intensivists, neurologists, anesthesiologists, emergency physicians, and critical care nurses treating patients with urgent neurologic disorders. These are conditions that may potentially evolve rapidly and could need immediate medical or surgical intervention. Neurocritical Care provides a comprehensive overview of current developments in intensive care neurology, neurosurgery and neuroanesthesia and includes information about new therapeutic avenues and technological innovations. Neurocritical Care is the official journal of the Neurocritical Care Society.