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01.05.2007 | Original

Brain lesions in septic shock: a magnetic resonance imaging study

verfasst von: Tarek Sharshar, Robert Carlier, Francis Bernard, Céline Guidoux, Jean-Philippe Brouland, Olivier Nardi, Geoffroy Lorin de la Grandmaison, Jérôme Aboab, Françoise Gray, David Menon, Djillali Annane

Erschienen in: Intensive Care Medicine | Ausgabe 5/2007

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Abstract

Background

Understanding of sepsis-induced brain dysfunction remains poor, and relies mainly on data from animals or post-mortem studies in patients. The current study provided findings from magnetic resonance imaging of the brain in septic shock.

Methods

Nine patients with septic shock and brain dysfunction [7 women, median age 63 years (interquartile range 61–79 years), SAPS II: 48 (44–56), SOFA: 8 (6–10)] underwent brain magnetic resonance imaging including gradient echo T1-weighted, fluid-attenuated inversion recovery (FLAIR), T2-weighted and diffusion isotropic images, and mapping of apparent diffusion coefficient.

Results

Brain imaging was normal in two patients, showed multiple ischaemic strokes in two patients, and in the remaining patients showed white matter lesions at the level of the centrum semiovale, predominating around Virchow–Robin spaces, ranging from small multiple areas to diffuse lesions, and characterised by hyperintensity on FLAIR images. The main lesions were also characterised by reduced signal on diffusion isotropic images and increased apparent diffusion coefficient. The lesions of the white matter worsened with increasing duration of shock and were correlated with Glasgow Outcome Score.

Conclusion

This preliminary study showed that sepsis-induced brain lesions can be documented by magnetic resonance imaging. These lesions predominated in the white matter, suggesting increasedblood–brain barrier permeability, and were associated with poor outcome.

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Titel: Brain lesions in septic shock: a magnetic resonance imaging study
verfasst von: Tarek Sharshar
Robert Carlier
Francis Bernard
Céline Guidoux
Jean-Philippe Brouland
Olivier Nardi
Geoffroy Lorin de la Grandmaison
Jérôme Aboab
Françoise Gray
David Menon
Djillali Annane
Publikationsdatum: 01.05.2007
Verlag: Springer Berlin Heidelberg
Erschienen in: Intensive Care Medicine / Ausgabe 5/2007
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-007-0598-y

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Brain lesions in septic shock: a magnetic resonance imaging study