%0 Journal Article
%T Craniectom赤a descompresiva en encefalitis herp谷tica: Caso cl赤nico Decompressive craniectomy in herpes simplex encephalitis: Clinical case
%A Ra迆l Bustos B
%A Sebasti芍n Vigueras A
%A Jaime Pinto V
%J Revista chilena de pediatr赤a
%D 2012
%I Sociedad Chilena de Pediatr赤a
%X Introducci車n: La morbimortalidad de la encefalitis herp谷tica ha disminuido con el uso de aciclovir. Sin embargo, algunos pacientes pueden evolucionar con necrosis focal hemorr芍gica y edema cerebral con posterior elevaci車n de la presi車n intracraneal. Casos cl赤nicos: Reportamos el curso cl赤nico de dos ni os con encefalitis herp谷tica complicada con hipertensi車n intracraneal refractaria al tratamiento con sedaci車n profunda, agentes osm車ticos e hiperventilaci車n. Ambos pacientes desarrollaron signos de enclavamiento uncal por lo que se realiz車 una craniectom赤a descompresiva precoz, que permiti車 un control de la presi車n intracraneal y una evoluci車n neurol車gica favorable al alta. Conclusiones: La craniectom赤a descompresiva podr赤a ser considerada como una alternativa terap谷utica de rescate en pacientes con encefalitis herp谷tica e hipertensi車n endocraneana refractaria a la terapia medica. 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.
%K Herpes
%K encefalitis
%K craniectom赤a
%K ni os
%K Herpes
%K encephalitis
%K craniectomy
%K children
%U http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062012000500009