RU2641174C2 - Method for prediction of sepsis development in patients with nontraumatic intracerebral bleeding - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: computer tomography (CT) and/or magnetic resonance imaging (MRI) of the brain are performed, exploring the regions of the hippocampus and para-hippocampal gyrus. Upon detection of neuroimaging signs of circulatory disorders in the region of the hippocampus and parahippocampal gyrus, which manifest themselves in the form of an increase in the volume of hippocampus, increased density of the hippocampus and parahippocampal gyrus tissue due to hemorrhagic impregnation, hyperemia due to venous outflow amid development of dislocation syndrome caused by hemorrhage, sepsis development is predicted.EFFECT: expanded ability to predict sepsis development in patients of this group through evaluation of neuroimaging changes.6 dwg, 1 tbl, 3 ex

Description

The invention relates to medicine, in particular to a method for predicting the development of sepsis in patients with non-traumatic intracranial hemorrhage.

Known methods for conducting magnetic resonance imaging in patients with advanced atherosclerosis and intracerebral hemorrhage.

A known method for assessing the risk of ischemic cerebrovascular accident, which consists in conducting a contrasted T1-weighted spin-echo magnetic resonance imaging of the neck and head in thin sections in the axial plane, 1-3 mm thick, with the mandatory coverage of the region of bifurcation of the carotid arteries, with the introduction contrast medium - paramagnet (RU No. 2554213 C1, АВВ 5/055, А61К 49/06, 06/27/2015).

A known method for detecting sensorimotor zones responsible for locomotion in the cerebral cortex, including MRI in T1 MPR (Multiplanar reconstruction) mode and fMRI using a sensorimotor passive paradigm that simulates the supporting load when walking with the KORVIT apparatus, constructs an individual three-dimensional model of the head the brain of the subject with the application of activation zones on it and comparing the real anatomical formations of the brain with the data on MRI in T1 MPR modes (RU No. 2504329 C1, A61B 5/055, A61B 5/0488, A61N 2/00, 01/20/2014).

A known method for the differential diagnosis of ischemic strokes in the acute period of the disease, which consists in the fact that the patient is carried out in the dynamics of the first 48 hours after the onset of the stroke and for 7-8 days magnetic resonance imaging (MRI), including diffusion-weighted (DV-MRI) and MRI perfusion to determine the diffusion and perfusion characteristics of the brain and their “mismatch” zone (RU No. 2398504 C1, AB 5/00, 09/10/2010).

A known method for diagnosing changes in the perifocal region with small supratentorial intracerebral hemorrhages is that a patient with acute cerebrovascular accident is determined using a timed diffusion-weighted magnetic resonance imaging tomography to determine the bioenergetic state of the damaged part of the brain, and a timed MRI perfusion is determined using the brain by evaluating the speed of passage of the contrast medium along the microvasculature (RU No. 236338 0 C1, A61B 5/055, 08/10/2009).

Known methods for clinical diagnosis of septic complications.

A known method for diagnosing the septic process and predicting the development of septic complications, including clinical laboratory diagnostics (RU No. 2568870 C2, G01N 33/49, G01N33 / 50, 11.20.2015; RU No. 2524615 C2, G01N 33/49, 07.27.2014; RU No. 2517523 C1, G01N 33/48, G01N 33/68, 05.27.2014; RU No. 2374646 C1, G01N 33/48, 11.27.2009; RU No. 2358653 C1, A61B 8/00, G01N 33/48, 08.20.2009; RU No. 2315311 C1, G01N 33/52, 01/20/2008; RU No. 2312605 C1, A61B 10/00, G01N 33/48, 12/20/2007; RU No. 2296331 C1, G01N 33/53, 03/27/2007; RU No. 2248572 C2, G01N 33/48, G01N 33/68, 03/20/2005; RU No. 2236006 C1, G01N 33 / 48.10.09.2004; RU No. 2232392 C1, G01N 33/48, 07/10/2004; RU No. 2185628 C2, G01N 33/53, G01N 33/52, 07/20/2002; RU No. 2185624 C2, G01N 33/48, G01N 33/50, 07/20/2002; RU No. 2132065 C1, G01N 33/48, 06/20/1999; RU No. 2022268 C1 , G01N 33/48, 10.30.1994).

Known methods for diagnosing septic complications and determining the severity of the disease.

A known method for determining the state of septic disease, which is carried out by immunometric analysis, determine the content of peptide procalcitonin and / or the incomplete peptide formed from it, which is an indicator of the presence of sepsis, its severity and / or success of therapeutic treatment (RU No. 2137130 C1, G01N 33/53, G01N 33/577, 09/10/1999)

There is a method for predicting the severity of abdominal sepsis, for which omega-potential is recorded and, with its values from -14 to +20 mV, the possibility of developing septic shock with subsequent multiple organ failure is determined, with omega-potentials from -26 and lower, the risk of developing sepsis or severe sepsis with moderate organ dysfunction, with indicators of omega potential from -15 to -26 mV, a moderate to severe clinical course is determined - systemic inflammatory response syndrome, RU No. 2291515 C1, A61B 5/04, G01N 21/64, 08/27/2005.

A known method for the diagnosis of septic complications is that the enzyme immunoassay determines the level of sodium urethic peptide C-type (CNP) and if the level of CNP is elevated compared to normal levels, then it is concluded that the patient has septic complications or is at risk of developing septic complications (RU No. 2462719 C2, G01N 33/68, 09/27/2012).

In the analysis of known methods, predicting the development of sepsis in patients with the assessment of the state of brain structures taking a direct active part in the implementation of the immune response was not found.

A known method for the laboratory diagnosis of sepsis, including a blood test (RU No. 2423704 C1, G01N 33/50, G01N 33/52, 07/10/2011). The method is carried out for the diagnosis of sepsis in patients with hyperthermia of unknown etiology, with a deterioration in the condition of patients in a hospital, in patients of the intensive care unit, as well as in postoperative complications.

A known method for determining the degree of temporal-tentorial infringement of the brain stem by performing computed and / or magnetic resonance imaging of the brain and determining changes in the hippocampus and parahippocampal gyrus (RU No. 2503410 C1, A61B 5/055, 01/10/2014).

This technical solution was taken as the closest analogue of the invention.

The closest analogue method involves determining changes at the level of cutout of the cerebellar tent in the frontal projection and the degree of temporal-tentorial infringement of the brain stem is estimated by the magnitude of the displacement of the hook of the hippocampus and the para-hippocampal gyrus.

The closest analogue method increases the reliability of diagnosing the degree of temporal-tentorial infringement of the brain stem, but is limited to determining changes in the level of cutout of the cerebellar tent in the frontal projection.

The basis of the invention is the solution of the problem, which allows to increase and expand the ability to predict the development of sepsis in patients with non-traumatic intracranial hemorrhage, to provide neuroimaging studies to predict the development of sepsis in the implementation of the method.

The technical result of the invention is to provide a prediction of the development of sepsis in patients in the use of the hippocampus and the parahippocampal gyrus and the detection of neuroimaging signs of circulatory disorders in them.

According to the invention, this problem is solved due to the fact that the method for predicting the development of sepsis in patients with non-traumatic intracranial hemorrhage is carried out by performing computed tomography (CT) and / or magnetic resonance imaging (MRI) of the brain.

By CT and / or MRI, a neuroimaging study of the hippocampal region and the parahippocampal gyrus is performed.

If neuroimaging signs of circulatory disorders in the hippocampus and the parahippocampal gyrus are detected, the development of sepsis is predicted.

Neuroimaging signs of circulatory disorders in the hippocampus and the parahippocampal gyrus are manifested as an increase in the volume of the hippocampus, an increase in the density of the hippocampal tissue and the parahippocampal gyrus.

An increase in the volume of the hippocampus, an increase in the density of the tissue of the hippocampus and the parahippocampal gyrus occurs as a result of hemorrhagic impregnation, venous stasis due to impaired venous outflow against the background of the development of a dislocation syndrome caused by hemorrhage.

The applicant has not identified sources containing information about technical solutions identical to the invention, which allows us to conclude that it meets the criterion of "novelty."

Due to the implementation of the distinguishing features of the invention (in conjunction with the features indicated in the restrictive part of the formula), important new properties of the object are achieved.

Conducting a neuroimaging study using the CT and / or MRI of the hippocampal region and the parahippocampal gyrus increase the possibility of predicting the development of sepsis in patients with non-traumatic intracranial hemorrhage.

The detection of neuroimaging signs of circulatory disorders in the hippocampus and the parahippocampal gyrus allows us to predict the development of sepsis.

Neuroimaging signs of circulatory disturbances in the hippocampus and para hippocampal gyrus, manifested by an increase in the volume of the hippocampus and increased tissue density of the hippocampus and para hippocampal gyrus, caused by hemorrhage, expand the ability to predict the development of sepsis in patients with non-traumatic intracranial hemorrhage.

The applicant is not aware of any publications that would contain information on the influence of the distinguishing features of the invention on the achieved technical result. In this regard, we can conclude that the proposed technical solution meets the criterion of "inventive step".

The invention is as follows.

A method for predicting the development of sepsis in patients with non-traumatic intracranial hemorrhage is carried out by performing computed tomography (CT) and / or magnetic resonance imaging (MRI) of the brain.

With the help of CT and / or MRI, a neuroimaging study of the hippocampus and the parahippocampal gyrus is performed.

If neuroimaging signs of circulatory disorders in the hippocampus and the parahippocampal gyrus are detected, the development of sepsis is predicted.

Neuroimaging signs of circulatory disorders in the hippocampus and the parahippocampal gyrus are manifested as an increase in the volume of the hippocampus, an increase in the density of the hippocampal tissue and the parahippocampal gyrus.

An increase in the volume of the hippocampus, an increase in the density of the tissue of the hippocampus and the parahippocampal gyrus occurs as a result of hemorrhagic impregnation, venous stasis due to impaired venous outflow against the background of the development of a dislocation syndrome caused by hemorrhage.

Changes in the hippocampus are a marker of a systemic inflammatory response according to CT and / or MRI of the brain.

Involvement in the pathological process in non-traumatic intracranial hemorrhage of such anatomical structures of the brain as the hippocampus and parahippocampal gyrus is especially important, since the hippocampus is actively involved in the formation of a systemic inflammatory response in case of acute cerebral damage.

The hippocampus is a key structure of the limbic system of the brain, one of the main functions of which is the regulation of vegetative-visceral functions. The connections of the hippocampus with the structures of both the limbic system and with other parts of the brain determine its multifunctionality. Along with the hypothalamus and the dorsal vagal complex (vagus nuclei), the hippocampus is involved mainly in the formation of an immune response from the central nervous system to sepsis.

The hippocampus as the central and one of the most vulnerable structures of the limbic system of the brain is highly sensitive to hypoxia, ischemia, anoxia - pathophysiological processes that inevitably develop with intracranial hemorrhage.

Non-traumatic intracranial hemorrhage leads to circulatory disorders, which contributes to the development and manifestation of a pronounced systemic inflammatory response, which plays a crucial role in the initiation of sepsis. Confirmation of damage in the hippocampus and parahippocampal gyrus is determined by the results of a neuroimaging study of the brain.

A study in the field of the hippocampus and parahippocampal gyrus as specific structures of the brain to predict the development of sepsis and a systemic inflammatory response is new.

Neuroimaging signs of circulatory disorders in the area of the hippocampus and the hippocampal gyrus, manifested in the form of an increase in the volume of the hippocampus, increased tissue density of the hippocampus and the hippocampal gyrus and resulting from hemorrhagic impregnation, venous stasis due to disturbance of the venous outflow due to development of dislocation syndrome prediction of sepsis and are new in the implementation of the method.

The implementation of the method is confirmed by examples 1-3.

Example 1. Patient M., 58 years old, diagnosis: OHMK hemorrhagic type on the background of hypertensive crisis. Cerebro-ventricular hemorrhage with the formation of intracerebral hematoma of the temporal lobe and deep parts of the left hemisphere of the large brain with a breakthrough of blood into the ventricular system.

On CT scan of the brain upon admission to the hospital:

- In the left subcortical nuclei and the left temporal lobe there is a large intracerebral hematoma 49 × 30 × 66 mm in size with perifocal edema and a breakthrough of blood in the ventricles of the brain, lateral dislocation of the median structures and a rough left-side temporal-tentorial wedge (Fig. 1A).

- Deformation of the anterior left hippocampus; the paragippocampal gyrus has an increased density, increased in size due to a violation of the venous outflow due to the development of a dislocation syndrome and compression of the hematoma; increase in the density of the hippocampal tissue due to hemorrhage in the anteroposterior divisions of the left temporal lobe.

Damage to the left hippocampus and parahippocampal gyrus is clearly visualized already in the first 24 hours from the moment of development of intracranial nontraumatic hemorrhage in the left hemisphere of the brain.

In fig. 1B, 1B, the arrows indicate the location of the left parahippocampal gyrus and the left hippocampus.

Patient M., 24 hours after the development of stroke, decompressive trepanation of the skull was performed in the left frontoparietal-temporal region, removal of intracerebral hematoma. In the first postoperative day, a powerful systemic inflammatory response developed with a diagnosed focus of infection in the form of purulent tracheo-bronchitis and subsequent bilateral pneumonia.

48 hours after surgery for an intracerebral hematoma, a CT scan of the brain revealed the presence of blood in the ventricular system of the brain (Fig. Not shown).

On the 4th postoperative day, the development of sepsis was confirmed by laboratory semi-quantitative method for determining the level of procalcitonin in blood serum - above 2.0 ng / ml.

On the x-ray (not shown) of the chest organs on the 6th postoperative day, the transparency of the pulmonary fields is reduced due to the pronounced interstitial increase in the pulmonary pattern in all fields. X-ray picture of edema of the interstitial tissue - pulmonary edema. The roots are unstructured. Tracheostomy. Central venous catheter in superior vena cava. Partial muscle relaxation of the right dome of the diaphragm. The middle mediastinum is expanded.

The procalcitonin level determined by the semi-quantitative method is more than 10 ng / ml.

On the radiograph (not shown) of the chest organs in dynamics after 2 weeks, the amplification and severity of the pulmonary pattern (more in the upper lobe on the right) remains, lung tissue infiltration is not determined. The roots are structural. Relaxation of the right dome of the diaphragm. Central venous catheter in the right ventricle. Tracheostomy. The shadow of the mediastinum is expanded.

The procalcitonin level determined by the semi-quantitative method is 0.5 ng / ml.

Sepsis was stopped within 3 weeks.

On brain MRI (Fig. 2), 2 months after intracranial hemorrhage, changes in the left hippocampus were structured into irreversible atrophic ones.

Example 2. Patient E., 87 years old, with a long history of hypertension, with repeated history of stroke, was admitted to a multidisciplinary clinic on 01.04.2017 by ambulance. Upon receipt, consciousness is at the level of deep stunning. According to the CT scan of the brain, performed on 01.04.17, an acute intracerebral hematoma 5.5 × 4.0 × 5.15 cm (57 cm ³ ) surrounded by a zone of perifocal edema (up to 0.7 cm) is determined paraventricularly from the left. The density of hemorrhagic contents is 55-75 HU. No breakthrough of the contents into the ventricular lumen was detected, the body and the anterior horn of the left lateral ventricle are subtotally compressed, the external cerebrospinal fluid spaces at the level of the change zone are narrowed; middle structures are shifted to the right by 7.5 mm; base tanks are passable, not deformed. Replacement non-occlusive hydrocephalus, indirect CT signs of discirculatory encephalopathy. In fig. 3A, p3B, the arrows indicate: the left paragippocampal gyrus increased in volume (yellow arrow), an increase in the density of the brain tissue of the left paragippocampal gyrus is noted; changes in the left hippocampus in the form of hemorrhagic impregnation along the medial contour (red arrow).

Fig. 3A, 3B. CT of the brain of patient E. upon admission to the hospital. The yellow arrow indicates the increased left paragippocampal gyrus in volume (an increase in the density of the brain tissue of the left paragippocampal gyrus is noted); the red arrow indicates the left hippocampus with hemorrhagic impregnation along the medial contour.

Based on the results of the examination, the patient was diagnosed with hemorrhagic type ONMK in the LSMA pool. Examined by a neurosurgeon, the conclusion: given the hypertonic nature of the hemorrhage, the patient’s age, a few history of stroke, the location and volume of the hematoma, and the moderate dislocation of the median structures while preserving cerebrospinal fluid spaces, emergency neurosurgical intervention is currently considered inappropriate. Conservative therapy in the intensive care unit is recommended. In the future, there was an increase in general cerebral symptoms, inhibition of the level of consciousness to coma II, transfer to mechanical ventilation.

According to the results of a CT scan of the brain from 04/04/2017 (Fig. 4A, 4B), an increase in hemorrhage from 57 cm ³ on the day of admission to 139 cm ³ is noted; lateral displacement of 12 mm (previously 7.5 mm), axial dislocation of 2-3 tbsp., hematoma breakthrough into the lumens of the left lateral and third ventricles with their tamponade. The anterior horn and the body of the left lateral ventricle are compressed. The hematoma also extends to the left leg of the brain, adjacent sections of the bridge. The enveloping tank is barely visible. The subarachnoid spaces of the brain furrows are symmetrically narrowed.

Fig. 4A, 4B. SKT of the brain of patient G. one day after admission.

In fig. 5A, 5B - total tamponade of the left lateral ventricle with an increase in its size, compression of the parahippocampal gyrus, hematoma spread to the anterior temporal lobe. The stage of hemorrhagic impregnation of the brain tissue of the parahippocampal gyrus and hippocampus.

Patient E. re-examined by a neurosurgeon - surgery is not shown.

From the second day of stay in the intensive care unit, the development of the syndrome of systemic inflammatory response (CER) is noted (see table 1).

Fig. 5A, 5B. Changes in the region of the left hippocampus and the parahippocampal gyrus in a day from the episode of stroke in hemorrhagic type in patient E.

A - total tamponade of the left lateral ventricle with an increase in its size. The yellow arrow indicates the compression of the left parahippocampal gyrus.

B - the spread of hematoma in the anterior sections of the left temporal lobe. The yellow arrow indicates hemorrhagic impregnation of the medulla of the left parahippocampal gyrus and the tissue of the left hippocampus.

The focus of infection in the form of purulent endobronchitis was verified in the patient three days after the onset and development of stroke. Reconstruction bronchoscopy was performed daily. The patient received antibacterial therapy with a wide spectrum of action. The development of sepsis was confirmed by laboratory semi-quantitative method for determining the level of procalcitonin in blood serum - above 2.0 ng / ml from 04/06/2017. Despite the ongoing therapeutic measures, 04/06/2017 against the background of progressive edema and dislocation of the brain, the death of the patient was ascertained.

Example 3. Patient K., 61 years old, was admitted to the clinic on his own on January 28, 2017 with complaints of a headache in the frontal region, decreased visual acuity, loss of visual fields, periodic nausea. A history of chronic diseases: GB; Ischemic heart disease; angina pectoris; type II diabetes mellitus; aortic valve prosthetics 04.2016. A persistent form of atrial fibrillation (AF). Constantly taking warfarin, MHO 2 days ago 2.4. There was no head injury.

After a comprehensive examination, including CT scan of the brain, a stationary diagnosis was made: hemorrhagic-type ONMC in the vertebro-basilar basin (WBM) with the formation of an intracerebral hematoma in the left occipital region with a volume of 37 cm ³ (42 × 43 × 42 mm) from 27.01. 2017. Middle structures are not displaced.

According to CT angiography of cerebral arteries, data for aneurysms, there is no malformation. Right-sided hemianopsia, right-sided pyramidal insufficiency. Atherosclerosis of the brachiocephalic arteries. Dyscirculatory, hypertensive encephalopathy 2 tbsp. Atherosclerotic cardiosclerosis. Aortic stenosis, aortic valve replacement with a mechanical prosthesis. Infectious endocarditis of the aortic valve in August 2016, clinical and laboratory remission. The constant form of AF, normosystole. CHF 2 f. class Type 2 diabetes. MHO upon admission 3.01.

MRI of the brain is planned to clarify the formation of the left occipital lobe on a 1.5 T tomograph due to the presence of a mechanical prosthesis of the aortic valve in the patient. Canceled anticoagulant therapy with warfarin due to the high risk of re-hemorrhage.

For the purpose of dynamic monitoring and intensive care, the patient was transferred from the neurological department to the intensive care unit. Patient K. was examined by a neurosurgeon, surgery is not shown.

On the second day from admission, there is a negative dynamics in the form of the appearance of mixed aphasia, anisocoria D <S, psychomotor agitation, moderate right-sided hemiparesis remains. Patient K. underwent an MRI of the brain on January 30, 2017: the formation in the junction of the left temporal and occipital lobes increased in size to 73 × 45 × 50 mm (previously 42 × 43 × 42 mm) due to volumetric hematoma exposure at a distance. The shell spaces of the left temporal lobe are also smoothed due to the volumetric exposure of the hematoma at a distance. Perifocal edema up to 9 mm. Furrows are flattened; the left lateral and III ventricles are compressed, the displacement of the median structures from left to right up to 8-9 mm; basal tanks are not deformed. The parahippocampal gyrus and hippocampus are not changed on both sides and have a signal of the same intensity in the T2 VI mode (Fig. 6). MP picture of discirculatory encephalopathy. MP signs of small areas of change in signal intensity are most likely a manifestation of amyloid angiopathy.

Re-examined by a neurosurgeon in connection with the increase in mass effect: there is no evidence for the need for emergency neurosurgical intervention, conservative management of the patient is recommended.

From the moment of receipt to 01/31/2017, there is a slow progression of cerebral and focal neurological symptoms with the development of moderately severe cerebral symptoms to moderate stunning, right-sided hemiplegia, the appearance and progression of aphatic disorders in the form of mixed aphasia.

In the next 5 days, the patient completely regressed cerebral disturbances, partially aphatic, with periodic increase. Despite the high risk of an increase in the hemorrhagic component, anticoagulant therapy with low molecular weight heparins was continued; there were no signs of an increase in the mass effect against the background of its conduct. Psychotic disorders in the form of auto-aggression, aggression to the medical staff regressed completely. After 10 days from hospitalization and admission to the intensive care unit, the patient was transferred to the neurological department for further treatment. Throughout the entire period of treatment in the intensive care unit, there were no significant clinical and laboratory signs of the development of a systemic inflammatory response syndrome in the patient: the patient did not have a fever, occasionally an increase in the value of C-reactive protein was recorded to a maximum of 18 mg / l, fibrinogen to 6.0 g / l , there was a single increase in the total number of leukocytes to 12 до10 ⁹ / L without a shift in the formula.

With a control brain MSCT performed on 02/09/2017, an increase in the zone of perifocal edema is determined with an increase in lateral dislocation of the median structures from left to right up to 20 mm at the level of the lateral ventricular bodies, compression of the left lateral and III ventricles, covering the cisterns with the hematoma remaining unchanged. Patient discussed with neurosurgeons. Given the patient’s neurological status (clear consciousness, focal neurological symptoms), neuroimaging data (negative dynamics in the form of an increase in the dislocation of the median structures), ongoing anticoagulant therapy with aortic valve replacement (fraxiparin 0.8 ml / day), the patient is shown neurosurgical intervention in the volume of application of the milling hole in the hematoma projection with its subsequent passive drainage by local anesthesia. Minimally invasive neurosurgical intervention was performed on the same day without complications in the conditions of local anesthesia, the patient was discharged from the hospital on the 32nd day. There were no purulent-septic complications during the hospital stay. A control MSCT study of the brain was performed on the eve of the patient’s discharge.

Example 3 shows how, in the absence of signs of circulatory disorders in the hippocampus and in the para-hippocampal gyrus, in the form of an increase in the volume of the hippocampus and para-hippocampal gyrus, increased tissue density of the hippocampus and para-hippocampal gyrus due to venous stasis due to impaired venous outflow against the background of the development of a dislocation syndrome, caused by hemorrhage in a patient with hemorrhagic type of stroke, who suffered an infectious endocarditis a year before hemorrhage with aortic prosthetics mechanical prosthetic valve performance, there was no run of developing clinically significant systemic inflammatory response syndrome and sepsis in step conservative treatment and after suffering minimally invasive neurosurgical intervention hematoma drainage through the burr hole.

The results obtained on the basis of Examples 1-3 confirm new possibilities for predicting the development of sepsis in patients with non-traumatic intracranial hemorrhages.

In the proposed method for predicting the development of sepsis in patients with non-traumatic intracranial hemorrhages, well-known forecasting and diagnostic technologies are widely used in medicine, and its practical use determines the compliance of the method with the criterion of "industrial applicability".

The proposed method for predicting the development of sepsis in patients with non-traumatic intracranial hemorrhage allows:

- increase the ability to predict the development of sepsis;

- expand the ability to predict the development of sepsis;

- to provide neuroimaging studies to predict the development of sepsis in the implementation of the method.

Claims (1)

A method for predicting the development of sepsis in patients with non-traumatic intracranial hemorrhages, carried out by performing computed tomography (CT) and / or magnetic resonance imaging (MRI) of the brain, characterized in that neuroimaging studies of the hippocampus and parahippocampal gyrus are performed by CT and / or MRI upon detection of neuroimaging signs of circulatory disorders in the hippocampus and the parahippocampal gyrus, which manifest as an increase in the volume of the hippocampi , Increasing the density of the tissue of the hippocampus and parahippocampal gyrus due to hemorrhagic impregnation, venous congestion due to a violation of the venous outflow in the background of the development of dislocation syndrome, caused by hemorrhage, and that predict the development of sepsis.

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