Neuroanatomy and Physiology of Brain Dysfunction in Sepsis

Sepsis-associated encephalopathy (SAE), a complication of sepsis, is often complicated by acute and long-term brain dysfunction . SAE is associated with electroencephalogram pattern changes and abnormal neuroimaging findings. The major processes involved are neuroinflammation , circulatory dysfunction, and excitotoxicity . Neuroinflammation and microcirculatory alterations are diffuse, whereas excitotoxicity might occur in more specific structures involved in the response to stress and the control of vital functions. A dysfunction of the brainstem , amygdala , and hippocampus might account for the increased mortality, psychological disorders, and cognitive impairment . This review summarizes clinical and paraclinical features of SAE and describes its mechanisms at cellular and structural levels.