Usefulness of neuromonitoring in herpes simplex virus encephalitis.
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概要
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We encountered a patient with herpes simplex virus (HSV) encephalitis and evaluated her clinical status by jugular bulb oxyhemoglobin saturation (SjO2) and transcranial Doppler sonography (TCD) monitoring. A 62-year-old female was admitted with fever, lethargy and myoclonic storm. The CT scan on admission revealed diffuse low-density areas in the temporal lobes bilaterally together with extensive brain swelling. Immediately after admission, barbiturate therapy was instituted to control the intracranial hypertension and myoclonic storm while monitoring SjO2, TCD, and intracranial pressure (ICP). Elevation of the SjO2 values and mean flow velocity in the bilateral cervical carotid arteries was accompanied by progression of the inflammation produced by HSV encephalitis that was confirmed by serial CT scan findings and the increase in C reactive protein. We discuss the advantages and problems associated with the neuromonitoring tools used in this case.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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