Alwan F, Mahdi D, Tayabali S, et al. - This study was attempted to evaluate whether cerebral MRI findings prognosticate the risk of cognitive impairment in thrombotic thrombocytopenic purpura. Researchers included a total of 131 patients who got an MRI after an acute thrombotic thrombocytopenic purpura event with severe headache or neurological symptoms, of whom 56% had abnormal imaging, which was more common in patients with neurological symptoms vs only headaches. In remission, 27% reported persistent cognitive symptoms and 65% percent also reported depression and 55% reported anxiety, regardless of presenting neurology. As seen in 67% of patients with marked intellectual impairment vs 19% of patients without intellectual impairment, the frontal lobe was disproportionally affected in these patients. Hyperintense white matter lesions was the primary MRI finding in these patients. A lower median verbal IQ and performance IQ was linked to an abnormal MRI. This study’s findings demonstrate that neurological symptoms are frequently correlated with an abnormal cerebral MRI scan, and white matter frontal lobe lesions are especially significant, leading to marked intellectual impairment. The data exhibited that there was evidence of anxiety and depression in over half of patients, regardless of neurological involvement at presentation.