頭蓋内圧モニタリングが有用であったＡ型インフルエンザに合併した急性壊死性脳症の１例

概要

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An 8-year-old girl with acute necrotizing encephalopathy (ANE) associated with influenza A virus infection is described. She had a sudden onset of high fever with severe diarrhea and was confused within 12 hours from the onset of the disease.Head CT scans showed characteristic pictures of ANE, which consisted of symmetric low density areas in the thalamus and cerebral periventricular white matter.A rapid diagnostic test for influenza A virus against her nasal discharge was positive. She received intensive therapy for decreasing the increased intracranial pressure (ICP), in the form of namely administration of mannitol, dexamethasone and barbiturates, and hypothermic treatment. An ICP monitoring sensor placed against her frontal-lobe white matter was indispensable for controlling her ICP. Her disturbed consciousness remained unchanged for 3 weeks. She had no convulsion during the course. Seven months later,motor nerve functions had recovered fully but mild learning disabilities remained.We report here the usefulness of ICP monitoring for the successful treatment of ANE associated with influenza A virus infection.
信州医学会の論文