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Neurocritical Care

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01-12-2010 | Practical Pearl

Decompressive Craniectomy for Acute Disseminated Encephalomyelitis

Authors: A. I. Ahmed, C. A. Eynon, L. Kinton, J. A. R. Nicoll, A. Belli

Published in: Neurocritical Care | Issue 3/2010

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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Title: Decompressive Craniectomy for Acute Disseminated Encephalomyelitis
Authors: A. I. Ahmed
C. A. Eynon
L. Kinton
J. A. R. Nicoll
A. Belli
Publication date: 01-12-2010
Publisher: Humana Press Inc
Published in: Neurocritical Care / Issue 3/2010
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-010-9420-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Decompressive Craniectomy for Acute Disseminated Encephalomyelitis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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