Related Experiment Video
Updated: May 15, 2026
10:35
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Herpes simplex encephalitis following microvascular decompression for trigeminal neuralgia
Hon Tang1, Francisco Falcone, Sam Eljamel
1Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, United Kingdom.
Journal of Neurosurgery
|January 8, 2013
Summary
Herpes simplex encephalitis (HSE) can occur after trigeminal nerve surgery. Early consideration of HSE is crucial for timely antiviral treatment in patients with meningitis symptoms post-surgery.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Trigeminal neuralgia is a condition causing severe facial pain.
- Microvascular decompression (MVD) is a surgical procedure to treat trigeminal neuralgia.
Observation:
- A 29-year-old woman developed meningitis symptoms one week after MVD surgery.
- Cerebrospinal fluid analysis revealed herpes simplex virus Type 1.
- The patient had a history of treatment-resistant trigeminal neuralgia.
Findings:
- This case represents the first reported instance of herpes simplex encephalitis (HSE) triggered by MVD.
- The patient received a 2-week course of intravenous acyclovir.
- The patient was successfully treated and discharged.
Implications:
- HSE should be considered in patients presenting with meningoencephalitic symptoms after MVD.
- Prompt diagnosis and antiviral treatment are essential for managing HSE.
- This case highlights a rare but serious complication of MVD surgery.
Related Concept Videos
01:26Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
01:18Viral Meningitis
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
01:25Arboviral Encephalitis
Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...