Neurologic complications of organ system failure

Neurologic manifestations of organ failure are common and occasionally represent a major portion of the morbidity associated with the primary illness. Largely, the neurologic sequelae can be divided into three groups. The first group includes metabolic disorders and is mainly manifested by encephalopathy. Encephalopathy crosses organ systems in terms of primary disease processes, and the underlying mechanism is as yet unresolved. The second group is related to structural abnormalities, mainly hemorrhage, due to hematologic or coagulation defects secondary to the primary illness. These lesions will frequently require surgical intervention with subsequent resolution of the neurologic signs. The third category consists of cerebral ischemia either regional or global. Symptoms and signs correlate well with the time interval and location of the ischemia. Therapy is directed toward reducing ischemic time, thereby reducing morbidity.