Decompressive craniectomy as a lifesaving intervention for acute disseminated encephalomyelitis (ADEM)

Algahtani, Hussein; Shirah, Bader; Alassiri, Ali H.; Al-Gahtani, Sarah

doi:10.1016/j.msard.2020.102612

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…The reports of fulminant demyelinating disease of the CNS requiring decompressive craniectomy are summarized in Table 1. So far, 17 cases have been reported (including the present case), with 8 cases of ADEM, 7–13 4 cases of AHL, 14–17 3 cases of TDLs, 18–20 and 2 cases of the Marburg variant of MS 21,22 . The age of onset ranged widely from 1 to 63 years, but 16 of 17 cases were in their 50s or younger, and 4 were children.…”

Section: Discussionmentioning

confidence: 69%

Fulminant demyelinating disease of the central nervous system effectively treated with a combination of decompressive craniectomy and immunotherapy: A case report and literature review

Ide,

Ebashi,

Eriguchi

et al. 2024

Clinical Case Reports

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Key Clinical MessageAccurately identifying fulminant demyelinating diseases is important for sudden onset of asymmetric cerebral white matter lesions with mass effect. Initially, immunotherapy should be administered; however, surgical intervention should be performed with poor response to medical management and evident signs of cerebral herniation.AbstractA case of fulminant demyelinating disease of the central nervous system that required decompressive craniectomy 8 days after symptom onset is presented. The patient recovered without sequelae after a combination of neurosurgery and immunotherapy with steroids and has remained relapse‐free for 4 years.

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Section: Discussionmentioning

confidence: 69%

Fulminant demyelinating disease of the central nervous system effectively treated with a combination of decompressive craniectomy and immunotherapy: A case report and literature review

Ide,

Ebashi,

Eriguchi

et al. 2024

Clinical Case Reports

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“…Moreover, patients with contrast-enhancing lesions or mass effect may have the greatest benefit from PLEX ( 66 ). In addition, for a few patients with intracranial mass effects, decompressive craniectomy may be a lifesaving intervention for such cases ( 67 , 68 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical Presentation and Outcomes of Acute Disseminated Encephalomyelitis in Adults Worldwide: Systematic Review and Meta-Analysis

Wen

et al. 2022

Front. Immunol.

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BackgroundAcute disseminated encephalomyelitis (ADEM) is a rare demyelinating disorder that is often misdiagnosed. To improve early diagnosis, we performed a systematic review and meta-analysis of clinical features, outcomes for ADEM in adults.MethodsThe PubMed, Embase, Web of Science and Cochrane Library databases were searched for studies reporting the clinical features of adults with ADEM between January 1990 and May 2021. A random-effects meta-analysis model was used to pool data on clinical features and functional outcomes.ResultsTwelve studies examining 437 adults with ADEM met the inclusion criteria. Overall, the clinical features and diagnostic findings observed in more than two-thirds of the patients were white matter lesions [87.1%, 95% confidence interval (CI)=75-95.6], polyfocal onset (80.5%, 95% CI=50.5-98.9) and pyramidal signs (68.7%, 95% CI =40.0-91.9). The mortality rate was 7.8% (95% CI = 3.3–13.5), and the risk of residual deficits was 47.5% (95% CI = 31.8–63.4).ConclusionsAdults with ADEM had worse outcomes than children. Clinicians should maintain high clinical suspicion for patients presenting with certain clinical features and diagnostic findings.

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“…Moreover, patients with contrastenhancing lesions or mass effect may have the greatest benefit from PLEX (66). In addition, for a few patients with intracranial mass effects, decompressive craniectomy may be a lifesaving intervention for such cases (67,68).…”

Section: Discussionmentioning

confidence: 99%

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Decompressive craniectomy as a lifesaving intervention for acute disseminated encephalomyelitis (ADEM)

Cited by 3 publications

References 14 publications

Fulminant demyelinating disease of the central nervous system effectively treated with a combination of decompressive craniectomy and immunotherapy: A case report and literature review

Fulminant demyelinating disease of the central nervous system effectively treated with a combination of decompressive craniectomy and immunotherapy: A case report and literature review

Clinical Presentation and Outcomes of Acute Disseminated Encephalomyelitis in Adults Worldwide: Systematic Review and Meta-Analysis

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