Decompressive craniectomy in case of herpes encephalitis

Hasan, Alya; Alsarraf, Lamya

doi:10.1007/s00381-019-04492-7

Cited by 3 publications

(9 citation statements)

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“…However, in-hospital mortality (20% [12/61]) and moderate to severe long-term functional disability (23% [14/61]) were also prevalent. 17-20,22-26,45-47,49,51,56,62,64-66…”

Section: Resultsmentioning

confidence: 99%

“…Decompressive craniectomy with or without concurrent temporal lobectomy was frequently reported in HSVE cases (72% [46/64]) in the setting of clinical deterioration and radiological evidence of elevated ICP. 8,16-19,21,22,24,25,28,30,33,38,40-43,46-54,56-59,61,62,64-67 However, temporal or frontal lobectomy without craniectomy was also sometimes reported (28% [18/64]) for surgical decompression in HSVE cases. 20,23,24,26,27,29,32-36,39,44,48,53,63 Although elevated ICP in HSVE often results from diffuse cerebral edema, numerous patients (19% [12/64]) developed frank hemorrhage that required surgical evacuation because of significant mass effect and neurological deterioration.…”

Section: Resultsmentioning

confidence: 99%

“…29,44,63 Notably, nearly all surgical patients with HSVE-associated seizures reported in the literature displayed additional evidence of severely elevated ICP before undergoing surgery. 8,[16][17][18][19][20]23,25,27,29,32,36,37,[41][42][43][44][45][46]50,52,58,64,65 Only one report in this review described ATL specifically to control medically refractory status epilepticus in a patient with acute HSVE. 12,55 This patient underwent a right ATL approximately 3 weeks after the onset of illness and ultimately achieved resolution of seizures with minimal functional impairment.…”

Section: Literature Reviewmentioning

confidence: 99%

“…However, in-hospital mortality (20% [12/61]) and moderate to severe long-term functional disability (23% [14/61]) were also prevalent. [17][18][19][20][22][23][24][25][26][45][46][47]49,51,56,62,[64][65][66] Seizures associated with HSVE were present in a sizable proportion (50% [30/60]) of cases before surgical intervention (Table ). The majority of patients (66% [20/30]) had isolated seizures, which ultimately did not recur in several patients after either temporal lobectomy alone 27 or lobectomy with concurrent decompressive craniectomy.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Decompressive craniectomy with or without concurrent temporal lobectomy was frequently reported in HSVE cases (72% [46/64]) in the setting of clinical deterioration and radiological evidence of elevated ICP. 8,[16][17][18][19]21,22,24,25,28,30,33,38,[40][41][42][43][46][47][48][49][50][51][52][53][54][56][57][58][59]61,62,[64][65][66][67] However, temporal or frontal lobectomy without craniectomy was also sometimes reported (28% [18/64]) for surgical decompression in HSVE cases. 20,23,24,26,27,29,[32][33][34][35][36]…”

Section: Literature Reviewmentioning

confidence: 99%

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Surgical Management in Herpes Simplex Encephalitis: Illustrative Case Report and Systematic Review of the Literature

et al. 2023

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BACKGROUND:Herpes simplex virus (HSV) is a common cause of viral encephalitis and can result in refractory seizures. Although HSV encephalitis (HSVE) is treated primarily with acyclovir, surgery can play a role in medically intractable cases.OBJECTIVE:To systematically review cases describing surgery for the treatment of severe HSVE. We also present an illustrative case of anterior temporal lobectomy (ATL) for refractory status epilepticus in a patient with unilateral HSVE. This case demonstrates one clinical context in which surgery can be a useful adjunct.METHODS:We performed a systematic review using PubMed and Google Scholar, including case reports and series describing surgical interventions for HSVE. Clinical data were extracted from 54 publications that incorporated 67 patient cases.RESULTS:Surgical decompression occurred at a wide range of times after the onset of illness, although most patients were operated on 4 or more days after HSVE symptoms began. Numerous reports indicated that decompressive craniectomy, temporal lobectomy, and hematoma removal could treat intractably elevated intracranial pressure because of HSVE with favorable long-term outcomes. We describe an additional case in which a 52-year-old woman with HSVE developed refractory right temporal lobe seizures. After ATL, the seizures resolved with significant clinical improvement.CONCLUSION:Surgical treatment can be a useful adjunct for treatment of HSVE. There is substantial variability in the timing of surgical decompression in patients with HSVE, which can be necessary up to approximately 3 weeks after illness onset. ATL should be considered for refractory status epilepticus in HSVE with a unilateral seizure focus.

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“…However, in-hospital mortality (20% [12/61]) and moderate to severe long-term functional disability (23% [14/61]) were also prevalent. 17-20,22-26,45-47,49,51,56,62,64-66…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

“…Decompressive craniectomy with or without concurrent temporal lobectomy was frequently reported in HSVE cases (72% [46/64]) in the setting of clinical deterioration and radiological evidence of elevated ICP. 8,[16][17][18][19]21,22,24,25,28,30,33,38,[40][41][42][43][46][47][48][49][50][51][52][53][54][56][57][58][59]61,62,[64][65][66][67] However, temporal or frontal lobectomy without craniectomy was also sometimes reported (28% [18/64]) for surgical decompression in HSVE cases. 20,23,24,26,27,29,[32][33][34][35][36]…”

Section: Literature Reviewmentioning

confidence: 99%

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Surgical Management in Herpes Simplex Encephalitis: Illustrative Case Report and Systematic Review of the Literature

et al. 2023

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Central Nervous System Infections and Their Management

Leclair

Hersh

2023

Pediatric Neurosurgery Board Review

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Meningoencephalitis with refractory intracranial hypertension: consider decompressive craniectomy

et al. 2023

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Decompressive craniectomy in case of herpes encephalitis

Cited by 3 publications

References 3 publications

Surgical Management in Herpes Simplex Encephalitis: Illustrative Case Report and Systematic Review of the Literature

Surgical Management in Herpes Simplex Encephalitis: Illustrative Case Report and Systematic Review of the Literature

Central Nervous System Infections and Their Management

Meningoencephalitis with refractory intracranial hypertension: consider decompressive craniectomy

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