Acute disseminated encephalomyelitis surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sujaya Chattopadhyay, M.D.[2]
Overview
Surgical interventions can be helpful for managing complications like cerebral edema, optic neuritis and elevated intracranial pressure. The options include:
- Decompressive hemi-craniectomy
- Bilteral optic nerve sheath decompression]]
- Lumboperitoneal shunting
Surgery
Decompressive hemi-craniectomy
It can be life-saving in patients with massive life-threatening cerebral oedema, refractory to conventional therapies[1][2].
Bilateral optic nerve sheath decompression[3]
In combination with high-dose steroids, it can be employed in patients having profound visual loss secondary to optic neuritis.
Lumboperitoneal shunt[3]
To lower elevated opening pressures on lumbar puncture
References
- ↑ von Stuckrad-Barre S, Klippel E, Foerch C, Lang JM, du Mesnil de Rochemont R, Sitzer M (2003). "Hemicraniectomy as a successful treatment of mass effect in acute disseminated encephalomyelitis". Neurology. 61 (3): 420–1. doi:10.1212/01.wnl.0000073540.35919.ae. PMID 12913218.
- ↑ Refai D, Lee MC, Goldenberg FD, Frank JI (2005). "Decompressive hemicraniectomy for acute disseminated encephalomyelitis: case report". Neurosurgery. 56 (4): E872, discussion E871. doi:10.1227/01.neu.0000156201.46473.a8. PMID 15792531.
- ↑ 3.0 3.1 Ellis BD, Kosmorsky GS, Cohen BH (1994). "Medical and surgical management of acute disseminated encephalomyelitis". J Neuroophthalmol. 14 (4): 210–3. PMID 7881525.