Neuropediatrics 2009; 40(4): 157-161
DOI: 10.1055/s-0029-1243626
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Fulminant Sepsis-Associated Encephalopathy in Two Children: Serial Neuroimaging Findings and Clinical Course

A. Kondo1 , C. Sugiura1 , Y. Fujii1 , T. Inoue1 , Y. Maegaki1 , K. Ohno1
  • 1Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan
Further Information

Publication History

received 06.05.2009

accepted 06.12.2009

Publication Date:
04 February 2010 (online)

Abstract

We report on two children with sepsis-associated encephalopathy. They presented with fulminant neurological damage on clinical, neuroimaging, and neurophysiological findings. At onset, both went into deep coma after status epilepticus, resulting in near brain death. Both patients showed diffuse brain edema on CT and severe brain dysfunction on electroencephalography within a day of onset. Brain magnetic resonance (MR) imaging of one patient on day 2 showed restricted diffusion in the basal ganglia and the subcortical white matter of the frontal and occipital lobes. Brain edema aggravated and lasted for a few months despite a variety of treatments. MR imaging in the chronic phase revealed cracking lesions extending to the cerebral white matter, the cerebellum, and the brainstem. MR angiography showed diminished intracranial major arteries. These serial neuroradiological findings suggested severe brain damage resulting from fulminant elevation of intracranial pressure, which mimicked “brain death” or “respirator brain”.

References

Correspondence

Akiko Kondo

Division of Child Neurology

Institute of Neurological Sciences

Faculty of Medicine

Tottori University

36-1 Nishi-cho

680-8504 Yonago

Japan

Phone: +81/859/38 6777

Fax: +81/859/38 6779

Email: holbergs@nifty.com