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Revista chilena de pediatría

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BUSTOS B, Raúl; VIGUERAS A, Sebastián  and  PINTO V, Jaime. Decompressive craniectomy in herpes simplex encephalitis: Clinical case. Rev. chil. pediatr. [online]. 2012, vol.83, n.5, pp.468-473. ISSN 0370-4106.

Introduction: The morbidity and mortality of herpes simplex encephalitis (HSE) have decreased with the use of acyclovir. However, some patients develop focal hemorrhagic necrosis and edema in the temporal lobe, with a subsequent elevation of intracranial pressure. Clinical cases: We report the clinical outcomes of two children with HSE who developed severe intracranial hypertension and impending uncal herniation refractory to profound sedation, osmotic agents and moderate hyperventilation. Decompressive craniectomy allowed an effective control of intracranial pressure and a favorable neurological outcome at discharge in both patients. Conclusions: Decompressive craniectomy could be considered as a rescue treatment strategy in patients with life-threatening intracranial hypertension due to severe herpetic encephalitis.

Keywords : Herpes; encephalitis; craniectomy; children.

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