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[Severe herpes simplex encephalitis: course 15 years following decompressive craniotomy].
Schweizerische Medizinische Wochenschrift
|July 25, 1992
Summary
Decompressive craniotomy significantly improved outcomes for two patients with severe herpes simplex virus encephalitis (HSE). This surgical intervention, combined with antiviral medication, led to substantial neurological recovery and long-term positive results.
Area of Science:
- Neurology
- Neurosurgery
- Infectious Diseases
Background:
- Herpes simplex virus encephalitis (HSE) can cause severe neurological deficits and mass effect.
- Medical management alone may be insufficient for HSE with brainstem compression.
Observation:
- Two patients with HSE presented with coma, hemiparesis, and space-occupying temporal lobe lesions causing brainstem compression.
- Surgical intervention via decompressive craniotomy with brain biopsy was performed.
Findings:
- Both patients received vidarabine (Ara-A) and corticosteroids post-operatively.
- Surgery resulted in impressive improvement, with neurological deficits regressing significantly within weeks.
- Long-term follow-up (15 years) showed both patients in satisfactory condition.
Implications:
- Decompressive craniotomy with duraplasty may be a critical therapeutic option for HSE unresponsive to medication.
- This surgical approach can mitigate severe neurological damage and improve long-term prognosis in HSE.
- Further research into surgical interventions for HSE is warranted.