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Incidence and pattern of brain lesions in paediatric septic shock patients

Debora Sanz1, Felice D'Arco2, Carlos Andres Robles2

  • 11 Paediatric Intensive Care Unit, Great Ormond Street Hospital for Children NHS Trust , London , UK.

The British Journal of Radiology
|January 3, 2018
PubMed

Insights

Brain injury is common in pediatric septic shock. Neuroimaging revealed acute lesions like cerebral infarcts and cerebritis in 10% of patients, aiding diagnosis and prognosis.

Area of Science:

  • Pediatric critical care medicine
  • Pediatric neurology
  • Neuroimaging in critical illness

Background:

  • Septic shock frequently causes brain injury through direct effects or secondary complications like hypotension and hypoxemia.
  • Assessing the incidence and patterns of brain lesions in pediatric septic shock is crucial for understanding outcomes.

Purpose of the Study:

  • To determine the incidence and patterns of brain lesions diagnosed by neuroimaging in pediatric patients experiencing septic shock.
  • To evaluate the role of neuroimaging in identifying acute intracerebral structural lesions and their reversibility.

Main Methods:

  • Retrospective descriptive study of pediatric patients with septic shock admitted to a tertiary pediatric intensive care unit (2010-2013).
  • Neuroimaging examinations included CT scans and/or MRI scans.
  • Analysis of neuroimaging findings to identify acute brain lesions.

Main Results:

  • Of 193 patients, 49 (25%) underwent neuroimaging (CT, MRI, or both).
  • Neuroimaging revealed acute lesions in 20 patients (40% of those imaged, 10% of the total cohort).
  • Most frequent findings were cerebral infarcts/hypoxic ischemic injury (16%) and cerebritis (14%).

Conclusions:

  • Neuroimaging is valuable for diagnosing brain dysfunction in septic shock, identifying structural lesions, and informing prognosis.
  • Ischemic lesions and cerebritis are the most common brain abnormalities in pediatric septic shock.
  • Neuroimaging aids in assessing lesion reversibility, guiding patient management.
Abstract

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