2022 Volume 34 Issue 2 Pages 7-14
Background: Encephalopathy is a common complication of sepsis that may result in worse outcomes. Effective treatment requires an understanding of the underlying mechanisms that cause this complication.
Materials and Methods: We investigated clinical, neurological, and brain MRI findings in five patients with sepsis-associated encephalopathy who were admitted to our hospital between 2016 and 2018.
Results: Age at symptom onset was high (61.6±12.9 years), with three patients having a history of hypertension. The Sequential Organ Failure Assessment score was high (11.6±4.82). Conscious disturbance appeared as a neurological complication in the early stages. The cause of sepsis was gastrointestinal infection in four patients. All five patients recovered from sepsis; however, four patients showed residual symptoms. We found slightly elevated protein levels in the cerebrospinal fluid. Brain MRI revealed multiple cerebral infarctions due to endothelial disturbance and vasogenic edema associated with disruption of the blood brain barrier.
Conclusion: While the underlying sepsis can often be successfully treated, patients with sepsis-associated encephalopathy can retain residual symptoms. Brain MRI revealed that the mechanism of sepsis-associated encephalopathy is endothelial disturbance and disruption of the blood brain barrier.
