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Neuroimaging Correlates of Acute Encephalopathy

Sutter, Raoul*,†; Kaplan, Peter W.

Journal of Clinical Neurophysiology: October 2013 - Volume 30 - Issue 5 - p 517–525
doi: 10.1097/WNP.0b013e3182a73be3
Invited Review

Summary: Acute encephalopathies arise as a result of various contributions from infections or toxic, metabolic, and/or structural cerebral derangements. With the variety of clinical presentations, neurologic examination, electroencephalography (EEG), and imaging may not identify specific etiologies, but in combination, they can offer guidance regarding underlying causes. Among several different neuroimaging techniques, cerebral computed tomography and brain magnetic resonance imaging are most frequently used for diagnosis, treatment monitoring, and prognostication in acute brain dysfunction. This review compiles the most common and typical features of head computed tomography and magnetic resonance imaging and presents the clinical and EEG associations in adult patients with different types of acute encephalopathy.

*Division of Neurosciences Critical Care, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.; and

Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, U.S.A. Dr. Raoul Sutter is now at the Department of Neurology and Intensive Care Unit, University Hospital Basel, Basel, Switzerland.

Address correspondence and reprint requests to Raoul Sutter, MD, Department of Neurology and Intensive Care Unit, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland, email:

R. Sutter is supported by the Research Fund of the University Basel, the Scientific Society Basel, and the Gottfried Julia Bangerter-Rhyner Foundation. P. W. Kaplan has provided unsponsored grand rounds, got paid for lectures by the American Clinical Neurophysiology Society (status epilepticus and epilepsy for which he received honoraria), and is on the Qatar Research Foundation grant on continuous EEG monitoring in status epilepticus and the National Institutes of Health study of children of mothers with epilepsy on antiepileptic medication.

© 2013 by the American Clinical Neurophysiology Society