Decompressive craniectomy in a case of intractable intracranial hypertension due to pneumococcal meningitis

A. Perin, E. Nascimben, P. Longatti

Research output: Contribution to journalArticlepeer-review

Abstract

A young woman suffering from S. pneumoniae meningitis developed intractable intracranial hypertension with a GCS of 3. Intracranial pressure (ICP) ranged above 30 mmHg despite maximal medical treatment and continuous CSF drainage. We performed a wide bilateral decompressive craniectomy (DC) with duraplasty and we observed an immediate and stable drop of her ICP. When discharged she was independent. DC has been rarely used to control ICP in encephalitis patients and recently only in one case of meningitis. This operation could be a valuable option when all other measures to decrease ICP have failed; when necessary, it should be performed according to some rules otherwise it could be harmful for the patient. Conclusive data on the impact of DC on the final outcome of such patients are not available yet.

Original languageEnglish
Pages (from-to)837-842
Number of pages6
JournalActa Neurochirurgica
Volume150
Issue number8
DOIs
Publication statusPublished - Aug 2008

Keywords

  • Decompressive craniectomy
  • Encephalitis
  • ICP
  • Intracranial hypertension
  • Meningitis
  • Streptococcus pneumoniae

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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