Decompressive hemicraniectomy for acute disseminated encephalomyelitis : Case report
Acute disseminated encephalomyelitis (ADEM) varies widely in symptoms and severity. Some cases are associated with massive life-threatening cerebral edema refractory to conventional medical management. A 51-year-old woman with ADEM who developed severe brain swelling and herniation despite aggressiv...
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| Veröffentlicht in: | Neurosurgery 2005-04, Vol.56 (4), p.E872; discussion E871-E872 |
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| container_end_page | E872 |
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| container_issue | 4 |
| container_start_page | E872; discussion E871 |
| container_title | Neurosurgery |
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| creator | REFAI, Daniel LEE, Max C GOLDENBERG, Fernando D FRANK, Jeffrey I |
| description | Acute disseminated encephalomyelitis (ADEM) varies widely in symptoms and severity. Some cases are associated with massive life-threatening cerebral edema refractory to conventional medical management.
A 51-year-old woman with ADEM who developed severe brain swelling and herniation despite aggressive medical management is described.
A decompressive hemicraniectomy and durotomy led to rapid improvement and an excellent outcome.
This case report reinforces the place of this procedure in the armamentarium of treatment options for patients with medically refractory brain swelling and elevated intracranial pressure caused by ADEM. The potential for an increase in the incidence of ADEM with more frequent smallpox vaccinations emphasizes the significance of redefining the full range of management options for this treatable disease. |
| doi_str_mv | 10.1227/01.NEU.0000156201.46473.A8 |
| format | Article |
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A 51-year-old woman with ADEM who developed severe brain swelling and herniation despite aggressive medical management is described.
A decompressive hemicraniectomy and durotomy led to rapid improvement and an excellent outcome.
This case report reinforces the place of this procedure in the armamentarium of treatment options for patients with medically refractory brain swelling and elevated intracranial pressure caused by ADEM. The potential for an increase in the incidence of ADEM with more frequent smallpox vaccinations emphasizes the significance of redefining the full range of management options for this treatable disease.</description><identifier>ISSN: 0148-396X</identifier><identifier>EISSN: 1524-4040</identifier><identifier>DOI: 10.1227/01.NEU.0000156201.46473.A8</identifier><identifier>PMID: 15792531</identifier><identifier>CODEN: NRSRDY</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Biological and medical sciences ; Brain - diagnostic imaging ; Craniotomy - methods ; Decompression, Surgical - methods ; Encephalomyelitis, Acute Disseminated - surgery ; Female ; Humans ; Intracranial Hypertension - etiology ; Medical sciences ; Middle Aged ; Neurosurgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Tomography, X-Ray Computed ; Treatment Outcome</subject><ispartof>Neurosurgery, 2005-04, Vol.56 (4), p.E872; discussion E871-E872</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-6721a5d6e3d670da4a9a4b2797e9c54c996dedebe0b37986b40c912cec3f7b83</citedby><cites>FETCH-LOGICAL-c404t-6721a5d6e3d670da4a9a4b2797e9c54c996dedebe0b37986b40c912cec3f7b83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16711327$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15792531$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>REFAI, Daniel</creatorcontrib><creatorcontrib>LEE, Max C</creatorcontrib><creatorcontrib>GOLDENBERG, Fernando D</creatorcontrib><creatorcontrib>FRANK, Jeffrey I</creatorcontrib><title>Decompressive hemicraniectomy for acute disseminated encephalomyelitis : Case report</title><title>Neurosurgery</title><addtitle>Neurosurgery</addtitle><description>Acute disseminated encephalomyelitis (ADEM) varies widely in symptoms and severity. Some cases are associated with massive life-threatening cerebral edema refractory to conventional medical management.
A 51-year-old woman with ADEM who developed severe brain swelling and herniation despite aggressive medical management is described.
A decompressive hemicraniectomy and durotomy led to rapid improvement and an excellent outcome.
This case report reinforces the place of this procedure in the armamentarium of treatment options for patients with medically refractory brain swelling and elevated intracranial pressure caused by ADEM. The potential for an increase in the incidence of ADEM with more frequent smallpox vaccinations emphasizes the significance of redefining the full range of management options for this treatable disease.</description><subject>Biological and medical sciences</subject><subject>Brain - diagnostic imaging</subject><subject>Craniotomy - methods</subject><subject>Decompression, Surgical - methods</subject><subject>Encephalomyelitis, Acute Disseminated - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Intracranial Hypertension - etiology</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>0148-396X</issn><issn>1524-4040</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkFtLwzAUgIMobk7_ghRB3zpza9Lsbcx5gaEvE3wLaXrKIu1ak1bYvzdzg52Xw-F858KH0B3BU0KpfMRk-r78nOIYJBM0llxwyabz_AyNSUZ5yjHH52iMCc9TpsTXCF2F8B3xyOWXaEQyqWjGyBitn8C2TechBPcLyQYaZ73ZOrB92-ySqvWJsUMPSelCiM2t6aFMYGuh25g6IlC73oVklixMgMRD1_r-Gl1Upg5wc8wTtH5erhev6erj5W0xX6U2PtinQlJislIAK4XEpeFGGV5QqSQom3GrlCihhAJwwaTKRcGxVYRasKySRc4m6OGwtvPtzwCh140LFurabKEdghYyE9nezATNDqD1bQgeKt151xi_0wTrvVKNiY5K9Ump_leq5_srt8crQ9FAeRo9OozA_REwwZq6ivqsCydOSEIYlewPrqqBSg</recordid><startdate>20050401</startdate><enddate>20050401</enddate><creator>REFAI, Daniel</creator><creator>LEE, Max C</creator><creator>GOLDENBERG, Fernando D</creator><creator>FRANK, Jeffrey I</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20050401</creationdate><title>Decompressive hemicraniectomy for acute disseminated encephalomyelitis : Case report</title><author>REFAI, Daniel ; LEE, Max C ; GOLDENBERG, Fernando D ; FRANK, Jeffrey I</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-6721a5d6e3d670da4a9a4b2797e9c54c996dedebe0b37986b40c912cec3f7b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Biological and medical sciences</topic><topic>Brain - diagnostic imaging</topic><topic>Craniotomy - methods</topic><topic>Decompression, Surgical - methods</topic><topic>Encephalomyelitis, Acute Disseminated - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Intracranial Hypertension - etiology</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>REFAI, Daniel</creatorcontrib><creatorcontrib>LEE, Max C</creatorcontrib><creatorcontrib>GOLDENBERG, Fernando D</creatorcontrib><creatorcontrib>FRANK, Jeffrey I</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>REFAI, Daniel</au><au>LEE, Max C</au><au>GOLDENBERG, Fernando D</au><au>FRANK, Jeffrey I</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Decompressive hemicraniectomy for acute disseminated encephalomyelitis : Case report</atitle><jtitle>Neurosurgery</jtitle><addtitle>Neurosurgery</addtitle><date>2005-04-01</date><risdate>2005</risdate><volume>56</volume><issue>4</issue><spage>E872; discussion E871</spage><epage>E872</epage><pages>E872; discussion E871-E872</pages><issn>0148-396X</issn><eissn>1524-4040</eissn><coden>NRSRDY</coden><abstract>Acute disseminated encephalomyelitis (ADEM) varies widely in symptoms and severity. Some cases are associated with massive life-threatening cerebral edema refractory to conventional medical management.
A 51-year-old woman with ADEM who developed severe brain swelling and herniation despite aggressive medical management is described.
A decompressive hemicraniectomy and durotomy led to rapid improvement and an excellent outcome.
This case report reinforces the place of this procedure in the armamentarium of treatment options for patients with medically refractory brain swelling and elevated intracranial pressure caused by ADEM. The potential for an increase in the incidence of ADEM with more frequent smallpox vaccinations emphasizes the significance of redefining the full range of management options for this treatable disease.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>15792531</pmid><doi>10.1227/01.NEU.0000156201.46473.A8</doi></addata></record> |
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| ispartof | Neurosurgery, 2005-04, Vol.56 (4), p.E872; discussion E871-E872 |
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| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Biological and medical sciences Brain - diagnostic imaging Craniotomy - methods Decompression, Surgical - methods Encephalomyelitis, Acute Disseminated - surgery Female Humans Intracranial Hypertension - etiology Medical sciences Middle Aged Neurosurgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Tomography, X-Ray Computed Treatment Outcome |
| title | Decompressive hemicraniectomy for acute disseminated encephalomyelitis : Case report |
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