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Acute disseminated encephalomyelitis: a report of two fulminant cases and review of literature.
- Source :
-
Neurologia i neurochirurgia polska [Neurol Neurochir Pol] 2008 Sep-Oct; Vol. 42 (5), pp. 458-62. - Publication Year :
- 2008
-
Abstract
- Although the prognosis of acute disseminated encephalitis (ADEM) has generally been reported as favorable, in a small subset of patients, fulminant cerebral edema requiring critical care and surgical management may develop. This article presents a 56-year-old woman who developed ADEM and died of central brain herniation secondary to medically intractable cerebral edema. Following this experience, we encountered a 32-year-old man who also developed central brain herniation despite best medical management. We performed an urgent decompressive hemicraniectomy and frontal lobectomy followed by intensive intracranial pressure management. Few recommendations are available to guide neurologists and neurosurgeons in the management of medically intractable cerebral edema of ADEM. In this report, we present our experience with two severe cases of ADEM, review the pertinent literature, and discuss options for improved management of fulminant cases.
- Subjects :
- Adult
Brain Edema diagnosis
Decompression, Surgical
Encephalocele diagnosis
Encephalomyelitis, Acute Disseminated diagnosis
Encephalomyelitis, Acute Disseminated physiopathology
Fatal Outcome
Female
Humans
Male
Middle Aged
Brain Edema etiology
Brain Edema surgery
Encephalocele etiology
Encephalocele surgery
Encephalomyelitis, Acute Disseminated complications
Subjects
Details
- Language :
- English
- ISSN :
- 0028-3843
- Volume :
- 42
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Neurologia i neurochirurgia polska
- Publication Type :
- Academic Journal
- Accession number :
- 19105115