Intensive care management of acute hemorrhagic leukoencephalitis with favorable neurologic outcome

Use of therapeutic plasma exchange in the management of acute hemorrhagic leukoencephalitis: a case report and review of the literature

“…No established treatment guidelines for AHLE exist, but initial management includes dehydrating agents to manage intracranial pressure and high‐dose corticosteroids for immunosuppression 21,22 . Continuous intracranial pressure monitoring is used to assess treatment response and to determine when surgical decompression measures are needed 23,24 . Therapy with intravenous immunoglobulin (IVIG) is also used in combination with corticosteroids after monotherapy fails 25 .…”

Pediatric Acute Hemorrhagic Leukoencephalitis: Report of a Surviving Patient and Review

“…Since Hurst's first description, !100 adult [4][5][6][7][8][9] and 10 pediatric [10,11] cases of AHLE have been reported. Of 7 pediatric cases confirmed by histologic testing, all were fatal, and all nonfatal cases were diagnosed on clinical and radiographic grounds alone.…”

Full recovery after acute hemorrhagic leukoencephalitis (Hurst's disease)

“…Death from brain edema is common within 1 week of onset of neurological symptoms, but patients have survived when treated with various combinations of corticosteroids, immunoglobulin, and cyclophosphamide, with most improvement after plasma exchange [3]. Occasionally these survivors have no obvious neurological sequelae, but comprehensive neuropsychometric testing has not been reported in follow-up [4,5,7]. We report a patient with Hurst's disease and full recovery with corticosteroids additionally documented by serial magnetic resonance imaging (MRI) and neuropsychometric testing.…”

“…The adult experience of AHLE is variable, and, as expected, due to high case fatality, the largest series of 38 cases is limited to autopsy material [3]. Of six reported anecdotal cases with survival, three patients were treated with surgical decompression to remove a large hematoma [3,4,5,7]. One of these six patients was treated with steroids, cyclophosphamide, plasma exchange, and the remainder with plasma exchange alone.…”