Bitsch A, Nau R, Hilgers R A, Verheggen R, Werner G, Prange H W
Department of Neurology, Georg-August University Göttingen, Germany.
Acta Neurol Scand. 1996 Oct;94(4):279-86. doi: 10.1111/j.1600-0404.1996.tb07066.x.
Focal neurologic deficits in sepsis frequently result from parenchymal lesions due to cerebral embolism. The aim of this study was to characterize clinical, laboratory and radiologic patterns of those patients.
Medical records of 30 patients with focal neurologic symptoms during sepsis were analyzed retrospectively.
24 patients (22 with infective endocarditis) had ischemic stroke. Cerebrospinal fluid (CSF) analyses revealed inflammation in 11 of 12 patients. Patients who died (11/24) suffered more frequently from secondary intracerebral hemorrhage (p = 0.0031), which was significantly associated with intravenous high-dose anticoagulation (p = 0.0059). Six patients had slowly progressive focal neurologic deficits without evidence for stroke. All showed CSF inflammation and three developed multiple cerebral abscesses.
There are two distinctive groups of patients with focal neurologic deficits during sepsis. One presents with stroke and CNS inflammation (septic embolic focal encephalitis). The other group develops slowly progressive focal neurologic deficits and sometimes multiple cerebral abscesses (septic metastatic focal encephalitis).
脓毒症中的局灶性神经功能缺损常由脑栓塞导致的实质病变引起。本研究旨在描述这些患者的临床、实验室及影像学特征。
回顾性分析30例脓毒症期间出现局灶性神经症状患者的病历。
24例患者（22例患有感染性心内膜炎）发生缺血性卒中。脑脊液（CSF）分析显示12例患者中有11例存在炎症。死亡患者（11/24）更常发生继发性脑出血（p = 0.0031），这与静脉高剂量抗凝显著相关（p = 0.0059）。6例患者出现缓慢进展的局灶性神经功能缺损，无卒中证据。所有患者均显示脑脊液炎症，3例发展为多发性脑脓肿。
脓毒症期间出现局灶性神经功能缺损的患者有两个不同的群体。一组表现为卒中及中枢神经系统炎症（脓毒性栓塞性局灶性脑炎）。另一组发展为缓慢进展的局灶性神经功能缺损，有时出现多发性脑脓肿（脓毒性转移性局灶性脑炎）。
