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Herpes simplex encephalitis: the role of surgical decompression
1Department of Neurosurgery, Changhua Christian Hospital, Changhua, Taiwan.
Surgical Neurology
|February 9, 2002
Summary
Surgical decompression may improve outcomes for patients with herpes simplex encephalitis (HSE) when accompanied by acyclovir treatment. Early detection of consciousness changes is crucial for timely intervention in HSE cases.
Area of Science:
- Neurology
- Neurosurgery
- Infectious Diseases
Background:
- Acyclovir is a standard treatment for herpes simplex encephalitis (HSE).
- The role of surgical decompression in HSE management is less understood.
- This study presents two cases of HSE treated with surgical decompression.
Observation:
- Two patients with HSE presented with impending uncal herniation.
- Case 1: Acyclovir initiated on day 11, decompression on day 13.
- Case 2: Acyclovir initiated on day 3, decompression on day 11.
Findings:
- Both patients received acyclovir and surgical decompression.
- Both patients experienced good neurological outcomes.
- Both patients were seizure-free at 12-month follow-up.
Implications:
- Early recognition of declining consciousness due to inflammatory mass effect in HSE is vital.
- Surgical decompression is indicated for impending uncal herniation or elevated intracranial pressure in HSE.
- Surgical decompression can be a beneficial adjunct to antiviral therapy in severe HSE cases, potentially improving patient outcomes.