Journal of the Formosan Medical Association
Volume 106, Issue 2, Supplement , Pages S7-S12, 2007

Impaired Cerebral Autoregulation in a Case of Severe Acute Encephalitis

  • Sheng-Jean Huang

      Affiliations

    • Department of Neurosurgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

Department of Neurology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

Received 9 December 2005; received in revised form 22 February 2006; accepted 4 April 2006.

The status of cerebral autoregulation (CA) is an important prognostic factor for acute head trauma, but the role of CA in patients with acute encephalitis has not been previously discussed. We present the case of a 30-year-old woman with severe acute encephalitis who underwent craniectomy for intractable increased intracranial pressure (ICP). Preoperatively, adjustments of blood pressure (BP) with simultaneous recording of changes in cerebral blood flow velocity with transcranial Doppler indicated increased ICP and impaired CA. Postoperatively, ICP declined remarkably but CA remained impaired when the relationship between spontaneous fluctuation of mean BP and ICP was analyzed. Increased ICP recurred again within 24 hours of the decompression surgery and caused death of the patient. We propose that evaluating the status of CA could be of prognostic importance in patients with severe encephalitis. [J Formos Med Assoc 2007;106(2 Suppl):S7-S12]

Key Words:  cerebral autoregulation , craniectomy , encephalitis , intracranial pressure

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PII: S0929-6646(09)60345-4

doi:10.1016/S0929-6646(09)60345-4

Journal of the Formosan Medical Association
Volume 106, Issue 2, Supplement , Pages S7-S12, 2007

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