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Craniectomy for acute disseminated encephalomyelitis.
1Neurology, Wellington Hospital, Newtown, New Zealand david.bourke@ccdhb.org.nz.
Practical Neurology
|September 26, 2020
Summary
A young patient with acute disseminated encephalomyelitis (ADEM) after Epstein-Barr virus infection required emergency surgery. The study reviews craniectomy evidence for ADEM and encephalitis management.
Area of Science:
- Neurology
- Pediatric Neurology
- Infectious Diseases
Background:
- Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory neurological condition.
- Epstein-Barr virus (EBV) infection can trigger ADEM.
- Severe ADEM can lead to increased intracranial pressure and brainstem compression.
Purpose of the Study:
- To present a case of ADEM following EBV infection requiring surgical intervention.
- To review the existing literature on the use of craniectomy in ADEM and infectious encephalitis.
- To propose a management strategy for severe cases.
Main Methods:
- Case report of a 17-year-old female patient.
- Emergency bifrontal craniectomy performed for intracranial pressure management.
- Literature review on craniectomy for ADEM and encephalitis.
Main Results:
- The patient underwent bifrontal craniectomy due to severe intracranial pressure and brainstem compression.
- The study discusses the limited but relevant evidence for craniectomy in these conditions.
Conclusions:
- Craniectomy can be a life-saving procedure in select cases of severe ADEM with intracranial hypertension.
- Further research is needed to establish clear guidelines for surgical management in ADEM and encephalitis.
