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Updated: Feb 9, 2026
04:41
Plaquing of Herpes Simplex Viruses
Published on: November 5, 2021
7.1K
Decompressive craniectomy as salvage treatment in herpes simplex encephalitis: Two case reports
Marija Kusulja1, Marija Santini2
1Department of Neuroinfections and Intensive Care Medicine, University Hospital for Infectious Diseases "Dr Fran Mihaljević", Zagreb, Croatia.
Summary
Herpes simplex encephalitis, a severe brain infection, can cause dangerous swelling. Early decompressive craniectomy in two young adults successfully prevented fatal brain herniation during acyclovir treatment.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Herpes simplex encephalitis (HSE) is a rare but serious neurological condition.
- Despite available antiviral therapies like acyclovir, HSE can lead to significant morbidity and mortality.
- Severe brain edema is a known complication of HSE.
Observation:
- This report details two cases of HSE in young, previously healthy adults.
- Both patients developed severe brain edema despite receiving standard acyclovir treatment.
- The edema posed an immediate threat of brain herniation.
Findings:
- Prompt surgical intervention with decompressive craniectomy was performed in both cases.
- Decompressive craniectomy effectively managed the severe brain edema.
- This intervention averted brain herniation and prevented fatal outcomes.
Implications:
- Decompressive craniectomy is a critical life-saving procedure for managing severe brain edema in HSE.
- This approach offers a viable option for patients with refractory edema, improving survival rates.
- Highlights the importance of multimodal management strategies in severe HSE cases.
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