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Sepsis-associated encephalopathy (SAE) is frequently encountered in sepsis and is often accompanied by neuroimaging findings indicating ischemia, hemorrhage, and edema. Posterior reversible encephalopathy syndrome (PRES) has been vastly underrecognized in previously reported cohorts of patients with sepsis and SAE. Our aim was to determine the prevalence and distinguishing clinical, neuroimaging, and electroencephalography features of PRES in SAE.In this prospective observational study, patients with radiologically identified PRES were selected from a consecutively enrolled cohort of 156 patients with SAE and assessed for neurological outcome using the extended Glasgow Outcome Scale for 12 months. Patients with SAE and PRES and other types of brain lesions were compared in terms of clinical and diagnostic workup features.Fourteen of 156 patients (8.9%) were determined to be radiologically compatible with PRES, whereas 48 patients displayed other types of acute brain lesions. Patients with PRES often showed lesions in atypical regions, including frontal lobes, the corpus callosum, and the basal ganglia. Source of infection was mostly gram-negative bacteria originating from pneumonia or intraabdominal infections. Patients with PRES were not different from other patients with SAE with brain lesions in terms of features of sepsis and neurological outcome. However, patients with PRES showed increased prevalence of seizures and intraabdominal source of infection.PRES is highly prevalent in SAE, often encompasses unusual brain regions, and usually presents with generalized seizures. Patients with SAE and PRES do not appear to have distinguishing clinical and diagnostic workup features. However, generalized seizures may serve as warning signs for presence of PRES in patients with SAE.

Amaç: Bu çalışmada seri halde supin ve pron pozisyonlarda T1 ve T2 ağırlıklı aksiyal ve sagital manyetik rezonans görüntüleme yapılan 40 sağlıklı insanda meduller konusun supin-pron pozisyon değişikliği ile uyarılan hareket aralığı değerlendirildi.Yöntem: Her bir denekte konus medullarisin ucu seviyesinde elektronik ölçekler kullanılarak konus medullaris ve ön dural yüzey arasındaki mesafeyi ve dural kesenin genişliğini ölçtük. Elde edilen veriler SPSS 15 kullanılarak değerlendirildi. Bulgular: Konus ucunun, denekler supin pozisyondan pron pozisyona getirildiğinde ortalama değer olarak spinal kanal genişliğinin %30±14’ü oranında yer değiştirdiği saptandı (p:0,0001). Yaş (0-18 ve >19 yaş) ve cinsiyet farklılığı konus ucunun hareketliliğinde istatistiksel olarak anlamlı faktörler değildi. Sonuç: Çalışmamız klinik olarak gergin omurilik şüphesi bulunan normal uzanımlı konus vakalarında güvenilir bir diyagnostik referans aralığı sunmaktadır., Objective: In this study, using a series of supine and prone positions T1 and T2 with weighted axial and sagittal magnetic resonance imaging, the movement interval of the conus medullaris stimulated by the supine-prone position change was assessed in 40 healthy subjects.Method: We measured the distance between the conus medularis and the front dural surface and the width of the dural sac using electronic scales at the tip level of the conus medullaris in each subject. The data obtained was evaluated using SPSS 15. Results: It was determined that the spinal canal width was decreased by 30% (p:0.0001) as the average value when the conical tip was brought to the prone position from supine. Age (0-18 and >19 years) and gender diversity were not statistically significant factors in the movement of the conus medullaris. Conclusion: Our study offers a reliable diagnostic reference range in cases of normal extension conus with clinically tense spinal cord suspicion.