ABSTRACT
We describe the case of a 19-year-old male diagnosed with Reye syndrome within the context of viral pericarditis and salicylate ingestion. He presented a fatal brain oedema without liver failure. Brain biopsies obtained during a decompressive craniectomy led to the diagnosis.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Aspirin/adverse effects , Reye Syndrome/surgery , Acyclovir/therapeutic use , Antiviral Agents/therapeutic use , Brain Edema/etiology , Brain Edema/therapy , Coma/etiology , Coma/therapy , Decompressive Craniectomy , Fatal Outcome , Glasgow Coma Scale , Humans , Magnetic Resonance Imaging , Male , Pericarditis/complications , Resuscitation , Seizures/etiology , Seizures/therapy , Virus Diseases/complications , Young AdultABSTRACT
Reye syndrome is a rare, but severe and often fatal disease. The etiology of the classical Reye syndrome is unknown, but it is typically preceded by a viral infection with a free interval of three to five days. The main physiopathological hypothesis is a mitochondrial metabolism insult causing acute liver failure and encephalopathy. Survivors present serious neurological sequelae. The treatment of Reye syndrome is usually medical with intensive care management. Herein, we present the clinical case of a six-month-old baby diagnosed with Reye syndrome with a fulminant hepatitis, who was successfully liver transplanted with an auxiliary partial orthotopic liver transplantation.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Aspirin/adverse effects , Liver Transplantation , Reye Syndrome/surgery , Humans , Infant , Liver Failure, Acute/chemically induced , Liver Failure, Acute/surgery , Male , Reye Syndrome/chemically induced , Reye Syndrome/pathology , Reye Syndrome/physiopathologyABSTRACT
We present two cases that demonstrate the occurrence of symptomatic arachnoid cysts after craniotomy. Both patients presented 1 year postoperatively with generalized seizures as the only symptom. Focal or localizing neurological signs were not present. Both patients responded well to shunting procedures.
Subject(s)
Arachnoid/diagnostic imaging , Craniotomy , Cysts/diagnostic imaging , Adenoma, Chromophobe/surgery , Adult , Arachnoid/surgery , Cerebrospinal Fluid Shunts , Child , Cysts/surgery , Female , Humans , Male , Pituitary Neoplasms/surgery , Postoperative Complications/diagnostic imaging , Reye Syndrome/surgery , Tomography, X-Ray ComputedABSTRACT
Cerebral edema may complicate the course of fulminant hepatic failure. Response to conventional therapy has been disappointing. We present a patient with fatal acetaminophen-induced fulminant hepatic failure, with signs and symptoms of cerebral edema, unresponsive to conventional medical therapy. Cranial decompression was carried out. A justification of the need for further evaluation of cranial decompression in such patients is presented.
Subject(s)
Acetaminophen/poisoning , Brain Edema/etiology , Chemical and Drug Induced Liver Injury , Adolescent , Brain Edema/surgery , Female , Humans , Liver Diseases/complications , Prognosis , Reye Syndrome/surgerySubject(s)
Blood Coagulation Disorders/etiology , Hemoperfusion/adverse effects , Reye Syndrome/surgery , Charcoal , Child , Female , Humans , Infant , MaleABSTRACT
Report of the successful use of a decompressive craniectomy for the encephalopathy of Reye's syndrome with increased intracranial pressure. The patient had failed to respond to all medical management.
Subject(s)
Brain Diseases/surgery , Craniotomy/methods , Intracranial Pressure , Reye Syndrome/surgery , Arginine/therapeutic use , Brain Edema/surgery , Cerebrospinal Fluid Shunts , Child , Glucose/therapeutic use , Glycerol/therapeutic use , Humans , Hydrocephalus/therapy , Male , Neomycin/therapeutic useABSTRACT
Scribner shunts were placed in nine patients, who had clinical and laboratory evidence of Reye's syndrome and ranged in age from four to fifteen years, to facilitate repeated, rapid exchanges of large volumes of blood. A method of inserting the Scribner shunt is described. Over a period of 30 to 90 minutes, 3 to 8 units of blood were easily exchanged without hemodynamic or mechanical difficulties. There were no infections; all shunts were removed from survivors after four to eight days without permanent sequelae.
