{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T06:00:06Z","timestamp":1780898406313,"version":"3.54.1"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"vor","delay-in-days":157,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Heat stroke is a life\u2010threatening emergency characterized by severe hyperthermia and acute central nervous system (CNS) dysfunction. We describe a 72\u2010year\u2010old man who was found unresponsive in his vehicle on a day with ambient temperatures exceeding 90\u00b0F. On arrival, his core temperature was 105.8\u00b0F, and Glasgow Coma Scale (GCS) score was 5. Despite prompt initiation of active cooling and supportive care with normalization of body temperature, the patient developed persistent and fluctuating encephalopathy. Extensive metabolic, infectious, and toxicologic evaluations were unrevealing. Thyroid\u2010stimulating hormone was normal, arterial blood gases showed no acid\u2013base derangements, ammonia and liver function tests were within normal limits, and urine toxicology was negative. Electroencephalography demonstrated diffuse cerebral slowing without epileptiform activity. Brain MRI performed approximately 1 week after admission under anesthesia, including diffusion\u2010weighted imaging, showed no acute abnormalities, revealing only mild age\u2010related atrophy and chronic small\u2010vessel ischemic changes. The patient\u2032s neurologic function failed to recover over a prolonged hospitalization, and he ultimately died following transition to comfort\u2010focused care on hospital Day 27. This case highlights that severe and persistent encephalopathy may occur in the setting of probable heat stroke despite unrevealing conventional neuroimaging and underscores the diagnostic uncertainty and limitations of MRI in evaluating heat\u2010related neurologic injury.<\/jats:p>","DOI":"10.1155\/crcc\/6609879","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:38:16Z","timestamp":1780897096000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heat Stroke Encephalopathy Without the Presence of Distinct Imaging Findings: Case Report and Review of Literature"],"prefix":"10.1155","volume":"2026","author":[{"given":"Ryan","family":"Sholes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0809-7689","authenticated-orcid":false,"given":"David J.","family":"Walz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Connelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Rigotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,7]]},"reference":[{"key":"e_1_2_8_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2018.10.004"},{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1810762"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmcp2210623"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1249\/jsr.0000000000001058"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.17053"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-13-63"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.5692\/clinicalneurol.cn-000755"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.5692\/clinicalneurol.49.634"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002340050392"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1432"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.jnen.0000186924.88333.0d"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-007-0612-0"},{"key":"e_1_2_8_13_2","volume-title":"Heat Stroke: Practice Essentials, Pathophysiology, Etiology","author":"Helman R. M.","year":"2022"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-510x(98)00037-9"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/14734220310016114"}],"container-title":["Case Reports in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crcc\/6609879","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crcc\/6609879","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crcc\/6609879","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:38:17Z","timestamp":1780897097000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crcc\/6609879"}},"subtitle":[],"editor":[{"given":"Naohiro","family":"Komura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crcc\/6609879"],"URL":"https:\/\/doi.org\/10.1155\/crcc\/6609879","archive":["Portico"],"relation":{},"ISSN":["2090-6420","2090-6439"],"issn-type":[{"value":"2090-6420","type":"print"},{"value":"2090-6439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-10-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6609879"}}