Meningoencephalitis with refractory intracranial hypertension: consider decompressive craniectomy

Choucha, Anis; Boissonneau, Sébastien; Beucler, Nathan; Graillon, Thomas; Ranque, Stéphane; Bruder, Nicolas; Fuentès, S.; Velly, Lionel; Dufour, Henry

doi:10.23736/s0390-5616.21.05397-2

Cited by 4 publications

(2 citation statements)

References 49 publications

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“…Decompression craniotomy is proven to have promising relieving effects on patients of this disease with refractory intracranial hypertension. Choucha et al [ 14 ] have successfully treated adult cases of meningoencephalitis through this method. Surgical excision was the selected method in this case due to the hypertension in the right posterior fossa causing the severe headaches.…”

Section: Discussionmentioning

confidence: 99%

Chronic Cerebellar Meningoencephalitis in Adulthood: A Report of a Rare Case

Velchev,

Burev,

Yankov

et al. 2024

Cureus

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The development of meningoencephalitis is a result of an inflammation of the meninges and the brain, which can cause neurological sequelae. Cerebellar meningoencephalitis in adult patients is extremely rare and requires special diagnostic approaches. The aim of this report is to present a rare case of meningoencephalitis and evaluate the diagnostic and therapeutic techniques. We present a 45-year-old male patient who has entered the neurosurgery clinic with a severe headache lasting for a month. Neurological status determines intracranial hypertension. Magnetic resonance tomography (MRT) showed evidence of hyperintense lesions with homogenous enhancement in the right hemisphere of the cerebellum. The patient underwent a suboccipital paramedian craniotomy to excise the lesions and for the pathohistological examination of the biopsy material. Biopsy examination found sections expressing an infection process causing chronic meningoencephalitis in the right hemisphere of the cerebellum. The patient was treated postoperatively with cephalothin 2 g every 12 hours for 14 days. Follow-up examinations proved a relief of the symptoms. Meningoencephalitis of the cerebellum and the meninges is a complication that may occur in adulthood, and surgical excision, biopsy examination, and antibiotic therapy are promising methods for managing the disease.

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Section: Discussionmentioning

confidence: 99%

Chronic Cerebellar Meningoencephalitis in Adulthood: A Report of a Rare Case

Velchev,

Burev,

Yankov

et al. 2024

Cureus

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“…Identification and treatment of the underlying cause, as well as the use of drugs to lower ICH, are common components of its management [20]. In refractory cases, surgical intervention (decompressive craniectomy) may be required to alleviate head pressure [21,22].…”

Section: Discussionmentioning

confidence: 99%

Astrocytoma Mimicking Herpetic Meningoencephalitis: The Role of Non-Invasive Multimodal Monitoring in Neurointensivism

Flato,

Pereira,

Costa

et al. 2023

Neurology International

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Neuromonitoring is a critical tool for emergency rooms and intensive care units to promptly identify and treat brain injuries. The case report of a patient with status epilepticus necessitating orotracheal intubation and intravenous lorazepam administration is presented. A pattern of epileptiform activity was detected in the left temporal region, and intravenous Acyclovir was administered based on the diagnostic hypothesis of herpetic meningoencephalitis. The neurointensivist opted for multimodal non-invasive bedside neuromonitoring due to the complexity of the patient’s condition. A Brain4care (B4C) non-invasive intracranial compliance monitor was utilized alongside the assessment of an optic nerve sheath diameter (ONSD) and transcranial Doppler (TCD). Based on the collected data, a diagnosis of intracranial hypertension (ICH) was made and a treatment plan was developed. After the neurosurgery team’s evaluation, a stereotaxic biopsy of the temporal lesion revealed a grade 2 diffuse astrocytoma, and an urgent total resection was performed. Research suggests that monitoring patients in a dedicated neurologic intensive care unit (Neuro ICU) can lead to improved outcomes and shorter hospital stays. In addition to being useful for patients with a primary brain injury, neuromonitoring may also be advantageous for those at risk of cerebral hemodynamic impairment. Lastly, it is essential to note that neuromonitoring technologies are non-invasive, less expensive, safe, and bedside-accessible approaches with significant diagnostic and monitoring potential for patients at risk of brain abnormalities. Multimodal neuromonitoring is a vital tool in critical care units for the identification and management of acute brain trauma as well as for patients at risk of cerebral hemodynamic impairment.

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Indications and scientific support for supratentorial unilateral decompressive craniectomy for different subgroups of patients: A scoping review

Beucler

2024

Acta Neurochir

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Meningoencephalitis with refractory intracranial hypertension: consider decompressive craniectomy

Cited by 4 publications

References 49 publications

Chronic Cerebellar Meningoencephalitis in Adulthood: A Report of a Rare Case

Chronic Cerebellar Meningoencephalitis in Adulthood: A Report of a Rare Case

Astrocytoma Mimicking Herpetic Meningoencephalitis: The Role of Non-Invasive Multimodal Monitoring in Neurointensivism

Indications and scientific support for supratentorial unilateral decompressive craniectomy for different subgroups of patients: A scoping review

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