Decompressive Craniectomy for Acute Disseminated Encephalomyelitis

Ahmed, Aminul I.; Eynon, C. Andrew; Kinton, Lucy; Nicoll, James A. R.; Belli, Antonio

doi:10.1007/s12028-010-9420-8

Cited by 41 publications

(27 citation statements)

References 13 publications

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“…Decompressive craniectomy in ADEM is reported rarely in medical literature [1,17,19,23]. The only reported cases concern four adult patients and indicate that decompression in adult patients with ADEM is effective and associated with a favorable outcome.…”

Section: Discussionmentioning

confidence: 98%

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Life-saving decompressive craniectomy for acute disseminated encephalomyelitis in a child: a case report

et al. 2012

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Section: Discussionmentioning

confidence: 98%

“…These children need to be managed in the ICU and may benefit from surgery. Mortality in ADEM varies from 1 to 12 % [1,2,12,18]. Refractory intracranial hypertension is the cause of death in such cases.…”

Section: Discussionmentioning

confidence: 99%

Life-saving decompressive craniectomy for acute disseminated encephalomyelitis in a child: a case report

et al. 2012

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“…It is relatively simple to perform and is not associated with significant risks or complications. The effectiveness of decompressive craniectomy with hyperacute forms of ADEM has been reported [7,[17][18][19]. It is particularly effective in acute neurological deterioration associated with significant mass effect and brain herniation, particularly in patients with compromised or at risk renal function, in whom the use of osmotic diurectics or other measures to control intracranial pressure may be limited.…”

Section: Discussionmentioning

confidence: 99%

Fulminant acute disseminated encephalomyelitis in renal transplant patient treated by decompressive craniectomy: a case report

Spencer¹,

Vela‐Duarte²,

Sandrian³

et al. 2014

Neurosci Discov

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Background: Acute disseminated encephalomyelitis (ADEM) is a rare demyelinating disease of the central nervous system that most commonly afflicts children and young adults and may be rarely seen in renal transplant patients. Most cases resolve with medical management; however, in some instances, the initial episode may evolve into a fulminant illness with malignant cerebral edema and elevated intracranial pressure that can result in a herniation syndrome with possible fatal consequences. Immediate relief of intracranial pressure is a priority and medical therapies alone may not suffice or may be precluded by compromised renal function. Case description: A case is presented of fulminant ADEM in a pediatric renal transplant patient associated with intracranial hypertension and an acute herniation syndrome with rapid neurological decline that was effectively treated with a decompressive craniectomy. The procedure was life-saving and resulted in a favorable outcome without inflicting any additional morbidity. Conclusion: Decompressive craniectomy is an effective way to rapidly reduce intracranial pressure in patients with malignant cerebral edema associated with fulminant ADEM and rapid neurological decline.

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“…Finally, in both ADEM and AHLE, the brain lesions can be associated with significant edema. The mass effect associated with these lesions can be life-threatening, and measures to reduce brain swelling, including hypothermia and craniectomy, may be needed [72][73][74][75]. In addition to demyelination, pathology in AHLE shows fibrinoid necrosis of small vessels [62].…”

Section: Ademmentioning

confidence: 99%

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

Geldern¹,

McPharlin

Becker

2012

Neurotherapeutics

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This chapter will review the spectrum of immunemediated diseases that affect the nervous system and may result in an admission to the neurological intensive care unit. Immunomodulatory strategies to treat acute exacerbations of neurological diseases caused by aberrant immune responses are discussed, but strategies for long-term immunosuppression are not presented. The recommendations for therapeutic intervention are based on a synthesis of the literature, and include recommendations by the Cochrane Collaborative, the American Academy of Neurology, and other key organizations. References from recent publications are provided for the disorders and therapies in which randomized clinical trials and large evidenced-based reviews do not exist. The chapter concludes with a brief review of the mechanisms of action, dosing, and side effects of commonly used immunosuppressive strategies in the neurocritical care unit.

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Decompressive Craniectomy for Acute Disseminated Encephalomyelitis

Cited by 41 publications

References 13 publications

Life-saving decompressive craniectomy for acute disseminated encephalomyelitis in a child: a case report

Life-saving decompressive craniectomy for acute disseminated encephalomyelitis in a child: a case report

Fulminant acute disseminated encephalomyelitis in renal transplant patient treated by decompressive craniectomy: a case report

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

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