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Decompressive hemicraniectomy for acute disseminated encephalomyelitis: case report
Daniel Refai1, Max C Lee, Fernando D Goldenberg
1Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Neurosurgery
|March 29, 2005
Summary
This case report highlights decompressive hemicraniectomy for severe brain swelling in Acute Disseminated Encephalomyelitis (ADEM). This surgical intervention offers a life-saving option for refractory cases, improving patient outcomes.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Acute Disseminated Encephalomyelitis (ADEM) presents with diverse clinical manifestations and varying severity.
- Some ADEM cases involve life-threatening cerebral edema unresponsive to standard medical treatments.
Observation:
- A 51-year-old woman with ADEM experienced severe brain swelling and herniation despite intensive medical management.
- The patient underwent a decompressive hemicraniectomy and durotomy.
Findings:
- The surgical intervention resulted in rapid clinical improvement and an excellent neurological outcome.
- This procedure is effective for managing medically refractory brain swelling and elevated intracranial pressure in ADEM.
Implications:
- Decompressive hemicraniectomy should be considered a vital treatment option for severe ADEM with refractory cerebral edema.
- The potential rise in ADEM incidence, possibly linked to vaccinations, necessitates a broader understanding of management strategies.