Jackson A C, Gilbert J J, Young G B, Bolton C F
Can J Neurol Sci. 1985 Nov;12(4):303-7. doi: 10.1017/s0317167100035381.
Twelve fatal cases of encephalopathy associated with sepsis were examined in a ten-year retrospective study. The sources of infection and organisms isolated were variable. Six of the patients had focal neurologic signs; five had seizures. The level of consciousness varied from drowsiness to deep coma, and electroencephalograms revealed diffuse or multifocal abnormalities. Computed tomographic head scans and cerebrospinal fluid examinations were usually unremarkable. Eight patients had disseminated microabscesses in the brain at autopsy. Four patients had proliferation of astrocytes and microglia in the cerebral cortex, a feature associated with metabolic encephalopathies. Additional findings included cerebral infarcts, brain purpura, multiple small white matter hemorrhages, and central pontine myelinolysis. Although sepsis may cause encephalopathy by producing disturbances in cerebral synaptic transmission and cerebral energy production through a toxic mechanism, bacterial invasion of the brain with the formation of disseminated microabscesses is also an important cause.
在一项为期十年的回顾性研究中，对12例与脓毒症相关的致命性脑病病例进行了检查。感染源和分离出的病原体各不相同。6例患者有局灶性神经体征；5例有癫痫发作。意识水平从嗜睡到深度昏迷不等，脑电图显示弥漫性或多灶性异常。计算机断层扫描头部扫描和脑脊液检查通常无明显异常。8例患者在尸检时脑部有弥漫性微脓肿。4例患者大脑皮质有星形胶质细胞和小胶质细胞增生，这是与代谢性脑病相关的特征。其他发现包括脑梗死、脑紫癜、多发性小的白质出血和中央桥脑髓鞘溶解。虽然脓毒症可能通过毒性机制干扰脑突触传递和脑能量产生而导致脑病，但细菌侵入大脑并形成弥漫性微脓肿也是一个重要原因。
