Scholarlink

Background <p>Encephalitis may present with increased intracranial pressure (ICP) levels but data on its impact is unknown. We aimed to highlight the associated etiologies, clinical characteristics, and prognostic significance of increased ICP in encephalitis.</p> Methods <p>This multicenter retrospective study analyzed adults with encephalitis across 18 hospitals in Houston and Baltimore from 2002 to 2023, describing factors associated with measurement of intracranial pressure and variables associated with elevated intracranial pressure, defined by a lumbar puncture (LP) opening pressure (OP) &gt; 30&#xa0;cmH<sub>2</sub>O.</p> Results <p>Among 647 adults with encephalitis, the most common etiologies were unknown (38%), viral (32.9%), autoimmune (18.1%), bacterial (6.2%), and fungal (2.5%), and these did not differ significantly between patients with or without OP measurement or between those with normal versus elevated OP. A total of 298 patients (46%) had OP measured; of these, 242 (81.2%) had an OP &lt; 30&#xa0;cmH<sub>2</sub>O and 56 (18.8%) had elevated OP (≥ 30&#xa0;cmH<sub>2</sub>O). Patients were more likely to undergo OP measurement if they were febrile, immunocompromised, or had abnormal brain magnetic resonance imaging (MRI) or electroencephalogram (EEG) findings (<i>p</i> &lt; 0.05). Patients with elevated OP more frequently presented with nuchal rigidity, were less likely to have abnormal EEG findings, had longer hospital length of stay, longer duration of mechanical ventilation, and worse clinical outcomes as defined by a Glasgow Outcome Scale score &lt; 4 (<i>p</i> &lt; 0.05). In this cohort, only three patients received nonconservative management of elevated ICP.</p> Conclusions <p>OP was measured in fewer than half of adults with encephalitis. Elevated OP was associated with longer hospital stays, prolonged mechanical ventilation, and worse clinical outcomes, yet was infrequently managed with targeted interventions. Notably, all three patients who underwent nonconservative ICP management survived, with two achieving complete or near-complete neurological recovery, suggesting potential benefit from targeted intervention in select cases.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Etiologies, Clinical Characteristics, and Prognostic Impact of Increased Intracranial Pressure in Adults with Encephalitis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月21日

查看全文
  • Hazim Allos,
  • Ashley Heck,
  • Paris Bean,
  • Rajesh Gupta,
  • Ralph Habis,
  • Romergryko G. Geocadin,
  • John Probasco,
  • Arun Venkatesan,
  • Rodrigo Hasbun

摘要

Background

Encephalitis may present with increased intracranial pressure (ICP) levels but data on its impact is unknown. We aimed to highlight the associated etiologies, clinical characteristics, and prognostic significance of increased ICP in encephalitis.

Methods

This multicenter retrospective study analyzed adults with encephalitis across 18 hospitals in Houston and Baltimore from 2002 to 2023, describing factors associated with measurement of intracranial pressure and variables associated with elevated intracranial pressure, defined by a lumbar puncture (LP) opening pressure (OP) > 30 cmH2O.

Results

Among 647 adults with encephalitis, the most common etiologies were unknown (38%), viral (32.9%), autoimmune (18.1%), bacterial (6.2%), and fungal (2.5%), and these did not differ significantly between patients with or without OP measurement or between those with normal versus elevated OP. A total of 298 patients (46%) had OP measured; of these, 242 (81.2%) had an OP < 30 cmH2O and 56 (18.8%) had elevated OP (≥ 30 cmH2O). Patients were more likely to undergo OP measurement if they were febrile, immunocompromised, or had abnormal brain magnetic resonance imaging (MRI) or electroencephalogram (EEG) findings (p < 0.05). Patients with elevated OP more frequently presented with nuchal rigidity, were less likely to have abnormal EEG findings, had longer hospital length of stay, longer duration of mechanical ventilation, and worse clinical outcomes as defined by a Glasgow Outcome Scale score < 4 (p < 0.05). In this cohort, only three patients received nonconservative management of elevated ICP.

Conclusions

OP was measured in fewer than half of adults with encephalitis. Elevated OP was associated with longer hospital stays, prolonged mechanical ventilation, and worse clinical outcomes, yet was infrequently managed with targeted interventions. Notably, all three patients who underwent nonconservative ICP management survived, with two achieving complete or near-complete neurological recovery, suggesting potential benefit from targeted intervention in select cases.