Brain Volume Changes in Patients with Acute Brain Dysfunction Due to Sepsis
Background Sepsis-induced brain dysfunction (SIBD) is often encountered in sepsis patients and is related to increased morbidity. No specific tests are available for SIBD, and neuroimaging findings are often normal. In this study, our aim was to analyze the diagnostic value of volumetric analysis of...
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| Veröffentlicht in: | Neurocritical care 2020-04, Vol.32 (2), p.459-468 |
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| description | Background
Sepsis-induced brain dysfunction (SIBD) is often encountered in sepsis patients and is related to increased morbidity. No specific tests are available for SIBD, and neuroimaging findings are often normal. In this study, our aim was to analyze the diagnostic value of volumetric analysis of the brain structures and to find out its significance as a prognostic measure.
Methods
In this prospective observational study, brain magnetic resonance imaging (MRI) sections of 25 consecutively enrolled SIBD patients (17 with encephalopathy and 8 with coma) and 22 healthy controls underwent volumetric evaluation by an automated segmentation method.
Results
Ten SIBD patients had normal MRI, and 15 patients showed brain lesions or atrophy. The most prominent volume reduction was found in cerebral and cerebellar white matter, cerebral cortex, hippocampus, and amygdala, whereas deep gray matter regions and cerebellar cortex were relatively less affected. SIBD patients with normal MRI showed significantly reduced volumes in hippocampus and cerebral white matter. Caudate nuclei, putamen, and thalamus showed lower volume values in non-survivor SIBD patients, and left putamen and right thalamus showed a more pronounced volume reduction in coma patients.
Conclusions
Volumetric analysis of the brain appears to be a sensitive measure of volumetric changes in SIBD. Volume reduction in specific deep gray matter regions might be an indicator of unfavorable outcome. |
| doi_str_mv | 10.1007/s12028-019-00759-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2340042990</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2919608611</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-42d8d866048aa9248003ea63eaab8534f088205c688d130ea16ef82901096be83</originalsourceid><addsrcrecordid>eNp9kF1PwyAUhonRuDn9A16YJt54Uz0HWgqXc35GE038uCWspa5L106gMfv3Mjs18cILwgEeXg4PIYcIpwiQnTmkQEUMKOOwTGUstsgQ05THIDlur-sEYy4ZG5A95-YANJNZuksGDFFkCWNDcnduddVEr23dLUw0menmzbgo7DxqX5nGu-ij8rNonHfeRD17sXJl1-S-akPdmci30ZNZusrtk51S184cbOYRebm6fJ7cxPcP17eT8X2csyz1cUILUQjOIRFaS5oIAGY0D0NPRcqSEoSgkOZciAIZGI3clIJKwPCtqRFsRE763KVt3zvjvFpULjd1rRvTdk5RlgAkVEoI6PEfdN52tgndKSpRchAcMVC0p3LbOmdNqZa2Wmi7UghqrVr1qlVQrb5Uq3UXR5vobrowxc-Vb7cBYD3gwlHQan_f_if2E7QYhpQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2919608611</pqid></control><display><type>article</type><title>Brain Volume Changes in Patients with Acute Brain Dysfunction Due to Sepsis</title><source>MEDLINE</source><source>ProQuest Central (Alumni Edition)</source><source>ProQuest Central UK/Ireland</source><source>SpringerLink Journals - AutoHoldings</source><source>ProQuest Central</source><creator>Orhun, Günseli ; Tüzün, Erdem ; Bilgiç, Başar ; Ergin Özcan, Perihan ; Sencer, Serra ; Barburoğlu, Mehmet ; Esen, Figen</creator><creatorcontrib>Orhun, Günseli ; Tüzün, Erdem ; Bilgiç, Başar ; Ergin Özcan, Perihan ; Sencer, Serra ; Barburoğlu, Mehmet ; Esen, Figen</creatorcontrib><description>Background
Sepsis-induced brain dysfunction (SIBD) is often encountered in sepsis patients and is related to increased morbidity. No specific tests are available for SIBD, and neuroimaging findings are often normal. In this study, our aim was to analyze the diagnostic value of volumetric analysis of the brain structures and to find out its significance as a prognostic measure.
Methods
In this prospective observational study, brain magnetic resonance imaging (MRI) sections of 25 consecutively enrolled SIBD patients (17 with encephalopathy and 8 with coma) and 22 healthy controls underwent volumetric evaluation by an automated segmentation method.
Results
Ten SIBD patients had normal MRI, and 15 patients showed brain lesions or atrophy. The most prominent volume reduction was found in cerebral and cerebellar white matter, cerebral cortex, hippocampus, and amygdala, whereas deep gray matter regions and cerebellar cortex were relatively less affected. SIBD patients with normal MRI showed significantly reduced volumes in hippocampus and cerebral white matter. Caudate nuclei, putamen, and thalamus showed lower volume values in non-survivor SIBD patients, and left putamen and right thalamus showed a more pronounced volume reduction in coma patients.
Conclusions
Volumetric analysis of the brain appears to be a sensitive measure of volumetric changes in SIBD. Volume reduction in specific deep gray matter regions might be an indicator of unfavorable outcome.</description><identifier>ISSN: 1541-6933</identifier><identifier>EISSN: 1556-0961</identifier><identifier>DOI: 10.1007/s12028-019-00759-8</identifier><identifier>PMID: 31187433</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Amygdala - diagnostic imaging ; Amygdala - pathology ; Anesthesia ; Atrophy ; Bacteria ; Brain - diagnostic imaging ; Brain - pathology ; Case-Control Studies ; Caudate Nucleus - diagnostic imaging ; Caudate Nucleus - pathology ; Cerebellar Cortex - diagnostic imaging ; Cerebellar Cortex - pathology ; Cerebellum - diagnostic imaging ; Cerebellum - pathology ; Cerebral Cortex - diagnostic imaging ; Cerebral Cortex - pathology ; Cerebral Infarction - diagnostic imaging ; Coma ; Coma - diagnostic imaging ; Coma - etiology ; Coma - physiopathology ; Consciousness ; Critical Care Medicine ; Enrollments ; Female ; Gram-positive bacteria ; Gray Matter - diagnostic imaging ; Gray Matter - pathology ; Hippocampus - diagnostic imaging ; Hippocampus - pathology ; Humans ; Intensive ; Internal Medicine ; Magnetic Resonance Imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Neurology ; Nosocomial infections ; Organ Size ; Original Work ; Patients ; Physiology ; Posterior Leukoencephalopathy Syndrome - diagnostic imaging ; Putamen - diagnostic imaging ; Putamen - pathology ; Sepsis ; Sepsis - complications ; Sepsis - physiopathology ; Sepsis-Associated Encephalopathy - diagnostic imaging ; Sepsis-Associated Encephalopathy - etiology ; Sepsis-Associated Encephalopathy - physiopathology ; Thalamus - diagnostic imaging ; Thalamus - pathology ; Ventilators ; White Matter - diagnostic imaging ; White Matter - pathology</subject><ispartof>Neurocritical care, 2020-04, Vol.32 (2), p.459-468</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2019</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-42d8d866048aa9248003ea63eaab8534f088205c688d130ea16ef82901096be83</citedby><cites>FETCH-LOGICAL-c375t-42d8d866048aa9248003ea63eaab8534f088205c688d130ea16ef82901096be83</cites><orcidid>0000-0003-0173-3604</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12028-019-00759-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2919608611?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21387,21388,27923,27924,33529,33530,33743,33744,41487,42556,43658,43804,51318,64384,64386,64388,72240</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31187433$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Orhun, Günseli</creatorcontrib><creatorcontrib>Tüzün, Erdem</creatorcontrib><creatorcontrib>Bilgiç, Başar</creatorcontrib><creatorcontrib>Ergin Özcan, Perihan</creatorcontrib><creatorcontrib>Sencer, Serra</creatorcontrib><creatorcontrib>Barburoğlu, Mehmet</creatorcontrib><creatorcontrib>Esen, Figen</creatorcontrib><title>Brain Volume Changes in Patients with Acute Brain Dysfunction Due to Sepsis</title><title>Neurocritical care</title><addtitle>Neurocrit Care</addtitle><addtitle>Neurocrit Care</addtitle><description>Background
Sepsis-induced brain dysfunction (SIBD) is often encountered in sepsis patients and is related to increased morbidity. No specific tests are available for SIBD, and neuroimaging findings are often normal. In this study, our aim was to analyze the diagnostic value of volumetric analysis of the brain structures and to find out its significance as a prognostic measure.
Methods
In this prospective observational study, brain magnetic resonance imaging (MRI) sections of 25 consecutively enrolled SIBD patients (17 with encephalopathy and 8 with coma) and 22 healthy controls underwent volumetric evaluation by an automated segmentation method.
Results
Ten SIBD patients had normal MRI, and 15 patients showed brain lesions or atrophy. The most prominent volume reduction was found in cerebral and cerebellar white matter, cerebral cortex, hippocampus, and amygdala, whereas deep gray matter regions and cerebellar cortex were relatively less affected. SIBD patients with normal MRI showed significantly reduced volumes in hippocampus and cerebral white matter. Caudate nuclei, putamen, and thalamus showed lower volume values in non-survivor SIBD patients, and left putamen and right thalamus showed a more pronounced volume reduction in coma patients.
Conclusions
Volumetric analysis of the brain appears to be a sensitive measure of volumetric changes in SIBD. Volume reduction in specific deep gray matter regions might be an indicator of unfavorable outcome.</description><subject>Amygdala - diagnostic imaging</subject><subject>Amygdala - pathology</subject><subject>Anesthesia</subject><subject>Atrophy</subject><subject>Bacteria</subject><subject>Brain - diagnostic imaging</subject><subject>Brain - pathology</subject><subject>Case-Control Studies</subject><subject>Caudate Nucleus - diagnostic imaging</subject><subject>Caudate Nucleus - pathology</subject><subject>Cerebellar Cortex - diagnostic imaging</subject><subject>Cerebellar Cortex - pathology</subject><subject>Cerebellum - diagnostic imaging</subject><subject>Cerebellum - pathology</subject><subject>Cerebral Cortex - diagnostic imaging</subject><subject>Cerebral Cortex - pathology</subject><subject>Cerebral Infarction - diagnostic imaging</subject><subject>Coma</subject><subject>Coma - diagnostic imaging</subject><subject>Coma - etiology</subject><subject>Coma - physiopathology</subject><subject>Consciousness</subject><subject>Critical Care Medicine</subject><subject>Enrollments</subject><subject>Female</subject><subject>Gram-positive bacteria</subject><subject>Gray Matter - diagnostic imaging</subject><subject>Gray Matter - pathology</subject><subject>Hippocampus - diagnostic imaging</subject><subject>Hippocampus - pathology</subject><subject>Humans</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Nosocomial infections</subject><subject>Organ Size</subject><subject>Original Work</subject><subject>Patients</subject><subject>Physiology</subject><subject>Posterior Leukoencephalopathy Syndrome - diagnostic imaging</subject><subject>Putamen - diagnostic imaging</subject><subject>Putamen - pathology</subject><subject>Sepsis</subject><subject>Sepsis - complications</subject><subject>Sepsis - physiopathology</subject><subject>Sepsis-Associated Encephalopathy - diagnostic imaging</subject><subject>Sepsis-Associated Encephalopathy - etiology</subject><subject>Sepsis-Associated Encephalopathy - physiopathology</subject><subject>Thalamus - diagnostic imaging</subject><subject>Thalamus - pathology</subject><subject>Ventilators</subject><subject>White Matter - diagnostic imaging</subject><subject>White Matter - pathology</subject><issn>1541-6933</issn><issn>1556-0961</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kF1PwyAUhonRuDn9A16YJt54Uz0HWgqXc35GE038uCWspa5L106gMfv3Mjs18cILwgEeXg4PIYcIpwiQnTmkQEUMKOOwTGUstsgQ05THIDlur-sEYy4ZG5A95-YANJNZuksGDFFkCWNDcnduddVEr23dLUw0menmzbgo7DxqX5nGu-ij8rNonHfeRD17sXJl1-S-akPdmci30ZNZusrtk51S184cbOYRebm6fJ7cxPcP17eT8X2csyz1cUILUQjOIRFaS5oIAGY0D0NPRcqSEoSgkOZciAIZGI3clIJKwPCtqRFsRE763KVt3zvjvFpULjd1rRvTdk5RlgAkVEoI6PEfdN52tgndKSpRchAcMVC0p3LbOmdNqZa2Wmi7UghqrVr1qlVQrb5Uq3UXR5vobrowxc-Vb7cBYD3gwlHQan_f_if2E7QYhpQ</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Orhun, Günseli</creator><creator>Tüzün, Erdem</creator><creator>Bilgiç, Başar</creator><creator>Ergin Özcan, Perihan</creator><creator>Sencer, Serra</creator><creator>Barburoğlu, Mehmet</creator><creator>Esen, Figen</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0173-3604</orcidid></search><sort><creationdate>20200401</creationdate><title>Brain Volume Changes in Patients with Acute Brain Dysfunction Due to Sepsis</title><author>Orhun, Günseli ; Tüzün, Erdem ; Bilgiç, Başar ; Ergin Özcan, Perihan ; Sencer, Serra ; Barburoğlu, Mehmet ; Esen, Figen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-42d8d866048aa9248003ea63eaab8534f088205c688d130ea16ef82901096be83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Amygdala - diagnostic imaging</topic><topic>Amygdala - pathology</topic><topic>Anesthesia</topic><topic>Atrophy</topic><topic>Bacteria</topic><topic>Brain - diagnostic imaging</topic><topic>Brain - pathology</topic><topic>Case-Control Studies</topic><topic>Caudate Nucleus - diagnostic imaging</topic><topic>Caudate Nucleus - pathology</topic><topic>Cerebellar Cortex - diagnostic imaging</topic><topic>Cerebellar Cortex - pathology</topic><topic>Cerebellum - diagnostic imaging</topic><topic>Cerebellum - pathology</topic><topic>Cerebral Cortex - diagnostic imaging</topic><topic>Cerebral Cortex - pathology</topic><topic>Cerebral Infarction - diagnostic imaging</topic><topic>Coma</topic><topic>Coma - diagnostic imaging</topic><topic>Coma - etiology</topic><topic>Coma - physiopathology</topic><topic>Consciousness</topic><topic>Critical Care Medicine</topic><topic>Enrollments</topic><topic>Female</topic><topic>Gram-positive bacteria</topic><topic>Gray Matter - diagnostic imaging</topic><topic>Gray Matter - pathology</topic><topic>Hippocampus - diagnostic imaging</topic><topic>Hippocampus - pathology</topic><topic>Humans</topic><topic>Intensive</topic><topic>Internal Medicine</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neurology</topic><topic>Nosocomial infections</topic><topic>Organ Size</topic><topic>Original Work</topic><topic>Patients</topic><topic>Physiology</topic><topic>Posterior Leukoencephalopathy Syndrome - diagnostic imaging</topic><topic>Putamen - diagnostic imaging</topic><topic>Putamen - pathology</topic><topic>Sepsis</topic><topic>Sepsis - complications</topic><topic>Sepsis - physiopathology</topic><topic>Sepsis-Associated Encephalopathy - diagnostic imaging</topic><topic>Sepsis-Associated Encephalopathy - etiology</topic><topic>Sepsis-Associated Encephalopathy - physiopathology</topic><topic>Thalamus - diagnostic imaging</topic><topic>Thalamus - pathology</topic><topic>Ventilators</topic><topic>White Matter - diagnostic imaging</topic><topic>White Matter - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Orhun, Günseli</creatorcontrib><creatorcontrib>Tüzün, Erdem</creatorcontrib><creatorcontrib>Bilgiç, Başar</creatorcontrib><creatorcontrib>Ergin Özcan, Perihan</creatorcontrib><creatorcontrib>Sencer, Serra</creatorcontrib><creatorcontrib>Barburoğlu, Mehmet</creatorcontrib><creatorcontrib>Esen, Figen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Neurocritical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Orhun, Günseli</au><au>Tüzün, Erdem</au><au>Bilgiç, Başar</au><au>Ergin Özcan, Perihan</au><au>Sencer, Serra</au><au>Barburoğlu, Mehmet</au><au>Esen, Figen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brain Volume Changes in Patients with Acute Brain Dysfunction Due to Sepsis</atitle><jtitle>Neurocritical care</jtitle><stitle>Neurocrit Care</stitle><addtitle>Neurocrit Care</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>32</volume><issue>2</issue><spage>459</spage><epage>468</epage><pages>459-468</pages><issn>1541-6933</issn><eissn>1556-0961</eissn><abstract>Background
Sepsis-induced brain dysfunction (SIBD) is often encountered in sepsis patients and is related to increased morbidity. No specific tests are available for SIBD, and neuroimaging findings are often normal. In this study, our aim was to analyze the diagnostic value of volumetric analysis of the brain structures and to find out its significance as a prognostic measure.
Methods
In this prospective observational study, brain magnetic resonance imaging (MRI) sections of 25 consecutively enrolled SIBD patients (17 with encephalopathy and 8 with coma) and 22 healthy controls underwent volumetric evaluation by an automated segmentation method.
Results
Ten SIBD patients had normal MRI, and 15 patients showed brain lesions or atrophy. The most prominent volume reduction was found in cerebral and cerebellar white matter, cerebral cortex, hippocampus, and amygdala, whereas deep gray matter regions and cerebellar cortex were relatively less affected. SIBD patients with normal MRI showed significantly reduced volumes in hippocampus and cerebral white matter. Caudate nuclei, putamen, and thalamus showed lower volume values in non-survivor SIBD patients, and left putamen and right thalamus showed a more pronounced volume reduction in coma patients.
Conclusions
Volumetric analysis of the brain appears to be a sensitive measure of volumetric changes in SIBD. Volume reduction in specific deep gray matter regions might be an indicator of unfavorable outcome.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31187433</pmid><doi>10.1007/s12028-019-00759-8</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-0173-3604</orcidid></addata></record> |
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| subjects | Amygdala - diagnostic imaging Amygdala - pathology Anesthesia Atrophy Bacteria Brain - diagnostic imaging Brain - pathology Case-Control Studies Caudate Nucleus - diagnostic imaging Caudate Nucleus - pathology Cerebellar Cortex - diagnostic imaging Cerebellar Cortex - pathology Cerebellum - diagnostic imaging Cerebellum - pathology Cerebral Cortex - diagnostic imaging Cerebral Cortex - pathology Cerebral Infarction - diagnostic imaging Coma Coma - diagnostic imaging Coma - etiology Coma - physiopathology Consciousness Critical Care Medicine Enrollments Female Gram-positive bacteria Gray Matter - diagnostic imaging Gray Matter - pathology Hippocampus - diagnostic imaging Hippocampus - pathology Humans Intensive Internal Medicine Magnetic Resonance Imaging Male Medicine Medicine & Public Health Middle Aged Mortality Neurology Nosocomial infections Organ Size Original Work Patients Physiology Posterior Leukoencephalopathy Syndrome - diagnostic imaging Putamen - diagnostic imaging Putamen - pathology Sepsis Sepsis - complications Sepsis - physiopathology Sepsis-Associated Encephalopathy - diagnostic imaging Sepsis-Associated Encephalopathy - etiology Sepsis-Associated Encephalopathy - physiopathology Thalamus - diagnostic imaging Thalamus - pathology Ventilators White Matter - diagnostic imaging White Matter - pathology |
| title | Brain Volume Changes in Patients with Acute Brain Dysfunction Due to Sepsis |
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