{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T18:07:00Z","timestamp":1784657220476,"version":"3.55.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurocrit Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats: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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      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)\u2009&gt;\u200930\u00a0cmH\n                      <jats:sub>2<\/jats:sub>\n                      O.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u2009&lt;\u200930\u00a0cmH\n                      <jats:sub>2<\/jats:sub>\n                      O and 56 (18.8%) had elevated OP (\u2265\u200930\u00a0cmH\n                      <jats:sub>2<\/jats:sub>\n                      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 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). 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\u2009&lt;\u20094 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In this cohort, only three patients received nonconservative management of elevated ICP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats: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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12028-026-02602-3","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T17:56:02Z","timestamp":1784656562000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Etiologies, Clinical Characteristics, and Prognostic Impact of Increased Intracranial Pressure in Adults with Encephalitis"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7335-9098","authenticated-orcid":false,"given":"Hazim","family":"Allos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Heck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paris","family":"Bean","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Habis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romergryko G.","family":"Geocadin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Probasco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Venkatesan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Hasbun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"issue":"2","key":"2602_CR1","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1093\/cid\/ciaa598","volume":"73","author":"M Le Mar\u00e9chal","year":"2021","unstructured":"Le Mar\u00e9chal M, Mailles A, Seigneurin A, et al. 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J.P.G. is a site investigator for a study sponsored by Genentech, outside the submitted work. All other authors declare no conflicts of interest related to this manuscript.","order":1,"name":"Ethics","label":"Conflicts of Interest","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"This retrospective study was approved by the University of Texas Health Committee for the Protection of Human Subjects, the Harris Health System Research and Sponsor Programs, the Memorial Hermann Research Review Committee, and the Johns Hopkins Institutional Review Board. Given the retrospective design and minimal risk to participants, the requirement for informed consent was waived by the respective Institutional Review Boards. For this type of study, formal consent is not required.","order":2,"name":"Ethics","label":"Ethical Approval\/Informed Consent","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"The authors used ChatGPT (OpenAI) solely for language editing. The artificial intelligence tool was not used for study design, data collection, data analysis, data interpretation, generation of scientific conclusions or for any other purpose.","order":3,"name":"Ethics","label":"Artificial Intelligence","group":{"name":"EthicsHeading","label":"Ethics"}}]}}