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Decompressive craniectomy for acute disseminated encephalomyelitis.

Decompressive craniectomy for acute disseminated encephalomyelitis.
Decompressive craniectomy for acute disseminated encephalomyelitis.
Background: Acute disseminated encephalomyelitis (ADEM) is a rare, acute demyelinating condition. Although it usually presents in an acute or subacute manner over days, its clinical course may be rapid with symptoms and signs of severe intracerebral mass effect secondary to cerebral oedema.

Methods: Case report and literature review.

Results: We report a case of a patient presenting with a hyperacute course manifested by rapid loss of consciousness and focal neurological signs. Management with emergency hemicraniectomy and steroids resulted in rapid neurological improvement and minimal long-term deficit.

Conclusions: We believe that only surgical decompression is likely to be life saving in similar cases of hyperacute cerebral oedema due to ADEM. The wide decompression performed was concordant with that indicated for traumatic brain swelling. Such aggressive management is vindicated by the rapid recovery shown by our patient within days of surgery and the finding of minimal neurological sequelae at 3 months.
decompressive craniectomy, acute disseminated encephalomyelitis
1541-6933
393-395
Ahmed, A.I.
175a1358-5255-4f20-8cf9-96fac237bc9f
Eynon, C.A.
9feb03bc-2559-4c1c-94ea-56a817f7e0c3
Kinton, L.
c4664185-20aa-4ca6-8e99-cb8fe938f491
Nicoll, J.A.R.
88c0685f-000e-4eb7-8f72-f36b4985e8ed
Belli, A.
173116e3-a9e8-4ed2-afc4-932f7001eeb0
Ahmed, A.I.
175a1358-5255-4f20-8cf9-96fac237bc9f
Eynon, C.A.
9feb03bc-2559-4c1c-94ea-56a817f7e0c3
Kinton, L.
c4664185-20aa-4ca6-8e99-cb8fe938f491
Nicoll, J.A.R.
88c0685f-000e-4eb7-8f72-f36b4985e8ed
Belli, A.
173116e3-a9e8-4ed2-afc4-932f7001eeb0

Ahmed, A.I., Eynon, C.A., Kinton, L., Nicoll, J.A.R. and Belli, A. (2010) Decompressive craniectomy for acute disseminated encephalomyelitis. Neurocritical Care, 13 (3), 393-395. (doi:10.1007/s12028-010-9420-8). (PMID:20711687)

Record type: Article

Abstract

Background: Acute disseminated encephalomyelitis (ADEM) is a rare, acute demyelinating condition. Although it usually presents in an acute or subacute manner over days, its clinical course may be rapid with symptoms and signs of severe intracerebral mass effect secondary to cerebral oedema.

Methods: Case report and literature review.

Results: We report a case of a patient presenting with a hyperacute course manifested by rapid loss of consciousness and focal neurological signs. Management with emergency hemicraniectomy and steroids resulted in rapid neurological improvement and minimal long-term deficit.

Conclusions: We believe that only surgical decompression is likely to be life saving in similar cases of hyperacute cerebral oedema due to ADEM. The wide decompression performed was concordant with that indicated for traumatic brain swelling. Such aggressive management is vindicated by the rapid recovery shown by our patient within days of surgery and the finding of minimal neurological sequelae at 3 months.

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More information

Published date: December 2010
Keywords: decompressive craniectomy, acute disseminated encephalomyelitis

Identifiers

Local EPrints ID: 183451
URI: http://eprints.soton.ac.uk/id/eprint/183451
ISSN: 1541-6933
PURE UUID: 7acfb79b-2f82-4940-be33-8b6efb05ef92
ORCID for J.A.R. Nicoll: ORCID iD orcid.org/0000-0002-9444-7246

Catalogue record

Date deposited: 03 May 2011 10:46
Last modified: 03 Dec 2019 01:52

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Contributors

Author: A.I. Ahmed
Author: C.A. Eynon
Author: L. Kinton
Author: J.A.R. Nicoll ORCID iD
Author: A. Belli

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