Neurocritical Care最新文献

{"title":"The Influence of Different Arterial Carbon Dioxide Levels on the Cerebrovascular Autoregulation Curve in a Porcine Cranial Window Model.","authors":"Sofie Dietvorst, Bavo Kempen, Veerle De Sloovere, Nikky Corthout, Geert Meyfroidt, Bart Depreitere","doi":"10.1007/s12028-025-02250-z","DOIUrl":"10.1007/s12028-025-02250-z","url":null,"abstract":"<p><strong>Background: </strong>Cerebrovascular autoregulation (CA) is the ability to maintain adequate cerebral blood flow (CBF) over a wide range of arterial blood pressures (ABPs). Carbon dioxide (CO₂) is a potent vasodilator, but its precise influence on CA remains incompletely understood.</p><p><strong>Methods: </strong>A porcine cranial window model, in which CBF can be measured directly in the pial arterioles while ABP is mechanically manipulated, is used to investigate the effect of partial pressure of CO₂ in arterial blood (PaCO₂) on CA capacity. Hypercapnia and hypocapnia were induced in 12 male piglets each by adjusting the respiratory rate. Once stable PaCO₂ levels of 60 and 25 mm Hg, respectively, were achieved, ABP was gradually increased in half of the animals or decreased in the other half beyond limits of CA by inflating a balloon in the aorta or inferior vena cava.</p><p><strong>Results: </strong>Before ABP manipulation, hypercapnia already induced significant vasodilation (+ 33.9%) and an increase in CBF (+ 20.5%), whereas hypocapnia did not alter diameter or CBF. Both hypercapnia and hypocapnia significantly reduced the ability to adjust arteriolar diameters in response to changes in ABP.</p><p><strong>Conclusions: </strong>During hypocapnia as well as hypercapnia, narrowing of the CA range with a shorter plateau between the upper and lower limit of autoregulation was observed, compared to normocapnia.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"541-550"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating IVF Shortages in the Neurocritical Care Unit.","authors":"Scott R DeBoer, Salia Farrokh, Melissa Dang, Romergryko G Geocadin","doi":"10.1007/s12028-025-02261-w","DOIUrl":"10.1007/s12028-025-02261-w","url":null,"abstract":"","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"363-367"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is a Second Transcranial Doppler Study Needed to Confirm Neurocirculatory Arrest?","authors":"Tiffany Eatz, Yosdely Cabrera, Frank Cabrera, Mohan Kottapally, Amedeo Merenda, Ayham Alkhachroum, Jose G Romano, Sebastian Koch","doi":"10.1007/s12028-025-02241-0","DOIUrl":"10.1007/s12028-025-02241-0","url":null,"abstract":"<p><strong>Background: </strong>In determining brain death, transcranial Doppler (TCD) is one of the recommended ancillary tests when clinical examinations and apnea tests are contraindicated. The American Academy of Neurology 2023 guideline updates and 2020 World Brain Death Project advise conducting two TCDs 30 min apart to diagnose neurocirculatory arrest. Our study aimed to evaluate whether a second TCD is necessary when the first TCD shows neurocirculatory arrest (no flow, oscillating flow, or systolic spikes).</p><p><strong>Methods: </strong>We conducted a single-center retrospective analysis of patients admitted to intensive care units from January 1, 2021, to February 1, 2025, at a community-based academic hospital. We included patients whose first study showed neurocirculatory arrest and who subsequently underwent a confirmatory TCD at least 30 min apart. A total of 48 patients were included in our final analysis. We compared the findings of the first TCD study with those of the second study and noted any differences.</p><p><strong>Results: </strong>In all 48 patients (100%), the second TCD confirmed the findings of the first TCD. Of these 48 patients, 44 patients (91.7%) had the same flow pattern on repeat TCD examination and 4 patients' (8.30%) TCDs showed different flow patterns, although still consistent with neurocirculatory arrest. Of the 44 patients with the same flow patterns found on first and repeat TCD examinations, 18 patients (40.9%) had both TCDs demonstrate brief systolic spikes; three patients (6.80%) had both TCDs demonstrate brief systolic spikes and oscillating flow; eight patients (18.2%) had both TCDs demonstrate no flow; seven patients (15.9%) had both TCDs demonstrate no flow and brief systolic spikes; one patient (2.30%) had both TCDs demonstrate no flow, brief systolic spikes, and oscillating flow; and, lastly, seven patients (15.9%) had both TCDs demonstrate oscillating flow.</p><p><strong>Conclusions: </strong>We found that requiring two sequential TCD examinations to confirm neurocirculatory arrest may be unnecessary when the first TCD shows neurocirculatory arrest. Further investigation and studies such as ours in larger populations are warranted.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"467-471"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optic Nerve Sheath Diameter Sonography for the Diagnosis of Increased Intracranial Pressure in Nontraumatic Neurocritically Ill Patients: a Diagnostic Accuracy Systematic Review and Meta-Analysis.","authors":"Rafael Hortêncio Melo, Luciana Gioli-Pereira, Fábio Santana Machado, Chiara Robba","doi":"10.1007/s12028-025-02249-6","DOIUrl":"10.1007/s12028-025-02249-6","url":null,"abstract":"<p><strong>Background: </strong>Optic nerve sheath diameter (ONSD) assessed by ultrasound is a feasible bedside method for increased intracranial pressure (IICP) diagnosis. However, most of the evidence relies on the population of patients with traumatic brain injury, with few data available on other populations. Consequently, its efficacy in nontraumatic critically ill patients remains underexplored. Our purpose was to examine the accuracy of ONSD ultrasonography for diagnosing IICP in nontraumatic neurocritically ill patients.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, Embase, and the Cochrane Library databases for comparative studies of adult nontraumatic critically ill patients that evaluated the accuracy of sonographic ONSD for IICP diagnosis compared with invasive or noninvasive reference standards. Two reviewers independently completed the search, data abstraction, and quality assessment with Quality Assessment of Diagnostic Accuracy Studies-2 tool. Heterogeneity was examined with I² statistics. We used a bivariate model of random effects to summarize pooled diagnostic odds ratio, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and summary receiver operating characteristic.</p><p><strong>Results: </strong>We included 18 observational studies, comprising 1,484 patients. Etiology of IICP was mixed, being composed of central nervous system infection, intracranial hemorrhage, acute ischemic stroke, aneurysmal subarachnoid hemorrhage, idiopathic intracranial hypertension, and hypoxic-ischemic brain injury. The pooled diagnostic odds ratio was 44.7 (95% confidence interval [CI] 22.5-80.1). Pooled sensitivity and specificity were 0.92 (95% CI 0.85-0.95) and 0.90 (95% CI 0.84-0.94), respectively, with a positive likelihood ratio of 6.19 (95% CI 4.4-8.5), and a negative likelihood ratio of 0.148 (95% CI 0.09-0.22). Summary receiver operating characteristic showed a calculated area under the curve of 0.925 (95% CI 0.84-0.927). Subgroup analysis of invasive and noninvasive reference standards showed similar accuracy of ultrasound ONSD for IICP diagnosis.</p><p><strong>Conclusions: </strong>Ultrasound ONSD may be a potentially useful noninvansive tool for IICP diagnosis in patients with nontraumatic brain injury.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"659-670"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of a Novel Automated Intelligent Suction Device (VapCare) Among Mechanically Ventilated Neurocritical Care Patients: A Prospective Randomized Trial.","authors":"M S Varnitha, P Murlidhara, Archana Sharma, V Sudhir, Shwetha S Naik, Dhritiman Chakrabarti","doi":"10.1007/s12028-025-02253-w","DOIUrl":"10.1007/s12028-025-02253-w","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia (VAP) is a significant concern in intensive care units (ICUs), affecting 7-32% of mechanically ventilated patients, which mounts to higher morbidity and mortality and extended hospital stays. Preventing VAP involves meticulous secretion management and oral hygiene, but in low-resource settings, VAP remains common owing to the absence of standardized oral care protocols. This randomized study assessed the efficacy and safety of the VapCare automated secretion management device in reducing microaspirations and improving clinical outcomes in ventilated patients.</p><p><strong>Methods: </strong>A single-center, open-label randomized trial was conducted involving adult neurocritical care patients requiring mechanical ventilation for 48 h or more, excluding tracheostomized patients and patients with bleeding disorders, difficult airways, or preexisting pneumonia. Participants were randomly assigned to a control group, receiving standard ICU care with manual oropharyngeal suctioning, or a study group, receiving VapCare management. We compared lung ultrasound scores (LUS), clinical pulmonary infection scores (CPIS), secretion volumes, tracheal cultures, and chest X-ray results from day 1 to day 5.</p><p><strong>Results: </strong>The VapCare group demonstrated a slower rise in LUS and CPIS compared to the control group. The median CPIS rose from 1 (interquartile range [IQR] 1-2) on the first day to 5 (IQR 2.75-6) on the fifth day in the control group versus 1 (IQR 0-2) on the first day to 3 (IQR 2-3) on the fifth day in the VapCare group (p < 0.001). The median LUS increased from 0 (IQR 0-2) on the first day to 6 (IQR 2-10) on the fifth in the control group, whereas the change was more muted in the VapCare group (0 [IQR 1-2] on the first day to 4 [IQR 2-6] on the fifth day [p < 0.001]). Additionally, chest X-ray scores were lower in the VapCare group (p = 0.028). Tracheal culture microbial growth and mortality were similar in both groups, but the length of ICU stay was significantly shorter in the VapCare group (p = 0.004). One patient in the VapCare group sustained mucosal erosions on the lip due to the VapCare mouthpiece.</p><p><strong>Conclusions: </strong>The VapCare device effectively reduces microaspiration and mitigates lung changes, demonstrating its potential to reduce the burden of microaspiration and suctioning in ventilated patients.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"551-562"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticoagulant Therapy for Cerebral Venous Sinus Thrombosis: A Propensity Score Matching Study and Inverse Probability Weighting.","authors":"Kai Liu, Mengmeng Zhang, Jiawei Zhao, Qinqin Dai, Yuan Gao, Shen Li, Lu Zhao, Yuming Xu, Bo Song","doi":"10.1007/s12028-025-02225-0","DOIUrl":"10.1007/s12028-025-02225-0","url":null,"abstract":"<p><strong>Background: </strong>New oral anticoagulants (NOACs) offer potential advantages for patients with cerebral venous sinus thrombosis (CVST). There is a lack of evidence to evaluate the efficacy and safety of NOACs in CVST. The purpose of this study was to compare the benefit and safety between NOACs and warfarin in patients with CVST.</p><p><strong>Methods: </strong>We performed a single-center prospective analysis including patients with CVST from the First Affiliated Hospital of Zhengzhou University between January 1, 2018, and December 31, 2021. The primary outcome was recurrent thrombotic events during the 6-month follow-up. Secondary outcomes included the modified Rankin scale (mRS) score, bleeding events, death, and cerebral venous recanalization during anticoagulant therapy. Propensity score matching (PSM) and inverse probability weighting (IPTW) were utilized to balance covariates between groups and mitigate selection bias in our study.</p><p><strong>Results: </strong>A total of 650 patients were identified. NOACs were used in 184 patients, and warfarin was used in 466 patients. Baseline characteristics were balanced between groups after IPTW or PSM. After 1:2 and 1:3 PSM, there were statistically significant differences between the two groups in death (2.2% vs. 8.0%, P = 0.014) and in mRS scores ≤ 2 (95. 1% vs. 88.7%, P = 0.020) in all patients. But there were no statistically significant differences between the two groups in recurrent CVST (odds ratio [OR] 0.543; 95% confidence interval [CI] 0.258-1.143; P = 0. 108), bleeding events (OR 0.823; 95% CI 0.074-9.143; P = 0.874), and partial/complete recanalization (OR 0.980; 95% CI 0.546-1.760; P = 0.946) in all patients. Similarly, there were no significant differences in patients who received anticoagulation therapy and in patients who received endovascular therapy plus anticoagulation therapy regarding any of the clinical outcomes. These results remained similar after IPTW analysis.</p><p><strong>Conclusions: </strong>Our study demonstrates that the use of NOACs in CVST has similar efficacy and safety compared to warfarin treatment. NOACs treatment may improve the clinical prognosis in patients with CVST.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"392-402"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eighteen-Year Trends in Subarachnoid Hemorrhage Management and Outcomes: A Single-Center Experience.","authors":"Marie Renaudier, Vincent Degos, Gianluca Pisanu, Benjamin Granger, Lamine Abdennour, Caroline Tabillon, Dany Hijazi, Anne-Laure Boch, Bertrand Mathon, Frédéric Clarençon, Eimad Shotar, Louis Puybasset, Rémy Bernard, Alice Jacquens","doi":"10.1007/s12028-025-02268-3","DOIUrl":"10.1007/s12028-025-02268-3","url":null,"abstract":"<p><strong>Background: </strong>Although subarachnoid hemorrhage-related mortality has decreased in recent years due to improvements in treatment, data on the evolution of 1-year functional outcomes after subarachnoid hemorrhage are lacking. The objective of this study was to evaluate the evolution of patient management and their functional outcomes 1 year after subarachnoid hemorrhage over time in a single high-volume neurosurgical intensive care unit.</p><p><strong>Methods: </strong>In this observational retrospective study, all consecutive patients with aneurysmal subarachnoid hemorrhage admitted to our neurosurgical intensive care unit between 2002 and 2019 were included. A poor functional outcome was defined as a modified Rankin Scale score of 4-6. Linear regressions were performed, and relative risk reductions of a poor functional outcome were calculated.</p><p><strong>Results: </strong>Between 2002 and 2019, 1556 patients were included, of whom 329 (21%) had a poor functional outcome. Over time, the percentage of coiling procedures (p = 0.004) increased, and the percentage of delayed cerebral ischemia (p = 0.03) decreased. One-year mortality decreased over time (p < 0.001), whereas 1-year functional outcome improved (p = 0.002), with a relative risk reduction of poor functional outcomes of 38% (17-54%).</p><p><strong>Conclusions: </strong>The 1-year functional outcome of patients with subarachnoid hemorrhage improved between 2002 and 2019, and mortality decreased.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"598-606"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Understanding of Cerebrovascular Hemodynamic Perturbations in Pediatric Cerebral Malaria Using a Modified Critical Closing Pressure Evaluation- A Prospective, Observational Study.","authors":"Nicole F O'Brien, Madiha Q Raees, Hunter J Wynkoop, Mengxin Yu, Dylan Small, Karl B Seydel, Montfort Bernard Gushu, Tusekile Phiri, Sylvester June, Terrie E Taylor","doi":"10.1007/s12028-025-02245-w","DOIUrl":"10.1007/s12028-025-02245-w","url":null,"abstract":"<p><strong>Background: </strong>Cerebral malaria (CM) results in significant mortality globally. Abnormal cerebral blood flow (CBF) has been described in CM and may contribute to poor outcomes. Changes to vascular tone may be contributing to flow aberrations but measuring it in the clinical setting is difficult. Critical closing pressure (CrCP) is calculated as CrCP = intracranial pressure (ICP) + vascular tone + venous pressure. If CrCPs other components are determined, vascular tone can be inferred. CrCP can also be used to determine the diastolic closing margin (DCM = diastolic blood pressure (DBP)-CrCP) which represents the lower safety limit of cerebral perfusion pressure.</p><p><strong>Methods: </strong>Children 6 months-12 years with CM and age-matched healthy controls were enrolled. Using concurrent transcranial doppler ultrasound (TCD) CBF velocities and systemic blood pressure measurements, CrCP was determined, and DCM calculated. Non-invasive estimates of ICP were assessed and venous flow was measured. Vascular tone was deduced. Differences in CrCP between controls and CM patients were determined. DCM and its association with outcome was assessed.</p><p><strong>Results: </strong>We enrolled 220 children with CM and 400 controls. In CM patients, there were significantly more children with CrCP > 1SD below (n = 37, 17%) and > 1 SD above (n = 42, 19%) the mean normal value of the control group (n = 15, 5% > 1SD below and n = 20, 5% > 1 SD above, p < 0.001 for both). Opening pressure, an estimate of ICP, was not different between patients and controls. Venous flows were higher in children with CM than controls, but no difference was seen in CM patients with CrCP less than, within, or greater than 1SD from normal. A DCM < 20mmHg conferred a relative risk of poor outcome (RR 1.4, 95%CI 1.2-1.9, p = 0.008).</p><p><strong>Conclusions: </strong>CrCP was > 1SD lower or higher than the mean normal value in a significant number of children with CM. A low DCM is associated with a worse prognosis and may serve as a therapeutic target.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"493-503"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Response to \"Second Transcranial Doppler to Confirm Cerebral Circulatory Arrest\".","authors":"Tiffany Eatz, Yosdely Cabrera, Frank Cabrera, Mohan Kottapally, Amedeo Merenda, Ayham Alkhachroum, Jose G Romano, Sebastian Koch","doi":"10.1007/s12028-025-02286-1","DOIUrl":"10.1007/s12028-025-02286-1","url":null,"abstract":"","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"708-709"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Description and Acute Outcomes of Cryptogenic Encephalitis in the Intensive Care Unit.","authors":"Jackson A Roberts, Mohamed Ridha, Carla Y Kim, Yifei Sun, Elizabeth Carroll, Jan Claassen, Kiran T Thakur","doi":"10.1007/s12028-025-02287-0","DOIUrl":"10.1007/s12028-025-02287-0","url":null,"abstract":"<p><strong>Background: </strong>Prognosis of acute encephalitis is variable and dependent on the underlying etiology, early treatment, and clinical course. Despite extensive evaluation, a cause of acute encephalitis may not be discovered, presenting a challenge to clinicians when discussing prognosis with families. We sought to determine whether clinical and radiographic features may discriminate short-term outcomes in patients with severe cryptogenic encephalitis.</p><p><strong>Methods: </strong>We performed a single-center, retrospective study of patients admitted with cryptogenic encephalitis (i.e., unknown etiology at time of discharge) to the Columbia University Irving Medical Center neurologic intensive care unit (ICU) and the Morgan Stanley Children's Hospital ICU from 2010 to 2020. A favorable discharge outcome was defined as Glasgow Outcome Scale score greater than or equal to 4. Using multivariable logistic regression modeling, we analyzed clinical and radiographic variables associated with favorable short-term outcome.</p><p><strong>Results: </strong>Among 204 total patients with encephalitis admitted to the ICU, 51.0% were classified as cryptogenic. The median age was 49.9 (interquartile range 31-64) years, and the most common presenting symptoms were altered mental status (74.0%), fever (56.7%), and headache (46.2%). Favorable outcome occurred in 63.5% of cryptogenic cases. In the fully adjusted model, age above 50 years (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.11-0.81; p = 0.017), active malignancy (OR 0.07, 95% CI 0.01-0.63; p = 0.018), and intubation (OR 0.20, 95% CI 0.07-0.55, p = 0.002) were associated with reduced odds of favorable outcome. Older age, active malignancy, and intubation were identified as predictors of lower Glasgow Outcome Scale score using ordinal logistic regression.</p><p><strong>Conclusions: </strong>Clinical characteristics may aid early prognostication of cryptogenic encephalitis. Further mechanistic study of the association between active malignancy among patients with cryptogenic encephalitis is warranted.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"636-644"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}