Cretin B, Collongues N, Philippi N, Blanc F
Département de neurologie, service de neuropsychologie, centre mémoire de ressources et de recherche d'Alsace, hôpitaux universitaires de Strasbourg, and UMR 7191, LINC, CNRS, université de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
Rev Neurol (Paris). 2011 Mar;167(3):195-204. doi: 10.1016/j.neurol.2010.07.019.
The sepsis associated encephalopathy (SAE) is a common cause of delirium, accompanied by hyperthermia or not. It is defined as a diffuse cerebral dysfunction induced by the systemic response to the infection without clinical or laboratory evidence of direct infectious involvement of the central nervous system. It is, thus, a diagnosis of exclusion. The pathogenic mechanisms underlying SAE are now better understood: it involves, at least, an intense inflammation of the central nervous system and a major impairment of the blood brain barrier. At the present time, clinical, biological and radiological characteristics of SAE have been sufficiently described to ensure rapid identification, but prognosis remains severe. Proper management requires treatment as early as possible of the infectious site and accompanying systemic inflammatory response. When appropriately conducted, minimal consequences or complete recovery can be expected.
脓毒症相关性脑病(SAE)是谵妄的常见病因,可伴有或不伴有高热。它被定义为对感染的全身反应所诱发的弥漫性脑功能障碍,而中枢神经系统并无直接感染累及的临床或实验室证据。因此,它是一种排除性诊断。目前对SAE的致病机制有了更好的理解:它至少涉及中枢神经系统的强烈炎症以及血脑屏障的严重损害。目前,SAE的临床、生物学和放射学特征已得到充分描述,以确保能快速识别,但预后仍然严峻。恰当的处理需要尽早治疗感染部位及伴随的全身炎症反应。如果处理得当,有望产生最小的后果或实现完全康复。