Abstract
Four patients with suspected herpes simplex encephalitis underwent cerebral biopsies using a stereotaxic technique coupled with computed tomography (CT) scanning. Typical histopathologic features of viral encephalitis were identified on frozen section, allowing rapid introduction of systemic antiviral therapy. Herpes simplex virus was isolated from cultures from the brain within 24-48 hours. Despite antiviral therapy, three patients died and the fourth patient remains severely neurologically impaired. Treatment was started too late in the clinical course to be effective. To reduce the strikingly high mortality and morbidity associated with herpes simplex encephalitis, a biopsy must be performed as early as possible to confirm the diagnosis or to exclude other treatable conditions. Appropriate antiviral therapy must be predicated on a positive biopsy and instituted immediately after diagnosis. We prefer the CT stereotaxic technique to other biopsy methods because it defines the involved locus in the brain, obviates the need for other time-consuming neurodiagnostic procedures, and provides 1-mm accuracy in reaching the desired biopsy site. Performed early in the clinical course, CT stereotaxic biopsy provides rapid histologic and virologic diagnosis and may eventually reduce the still unacceptably high mortality and morbidity associated with herpes simplex encephalitis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 249-257 |
| Number of pages | 9 |
| Journal | Surgical Neurology |
| Volume | 21 |
| Issue number | 3 |
| DOIs | |
| State | Published - 1984 |
| Externally published | Yes |
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Keywords
- Biopsy
- Computed tomography
- Diagnosis
- Herpes simplex encephalitis
- Stereotaxic technique
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Rapid and accurate diagnosis of herpes simplex encephalitis with computed tomography stereotaxic biopsy. / Lunsford, L. Dade; Martinez, A. Julio; Latchaw, Richard E; Pazin, George J.
In: Surgical Neurology, Vol. 21, No. 3, 1984, p. 249-257.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Rapid and accurate diagnosis of herpes simplex encephalitis with computed tomography stereotaxic biopsy
AU - Lunsford, L. Dade
AU - Martinez, A. Julio
AU - Latchaw, Richard E
AU - Pazin, George J.
PY - 1984
Y1 - 1984
N2 - Four patients with suspected herpes simplex encephalitis underwent cerebral biopsies using a stereotaxic technique coupled with computed tomography (CT) scanning. Typical histopathologic features of viral encephalitis were identified on frozen section, allowing rapid introduction of systemic antiviral therapy. Herpes simplex virus was isolated from cultures from the brain within 24-48 hours. Despite antiviral therapy, three patients died and the fourth patient remains severely neurologically impaired. Treatment was started too late in the clinical course to be effective. To reduce the strikingly high mortality and morbidity associated with herpes simplex encephalitis, a biopsy must be performed as early as possible to confirm the diagnosis or to exclude other treatable conditions. Appropriate antiviral therapy must be predicated on a positive biopsy and instituted immediately after diagnosis. We prefer the CT stereotaxic technique to other biopsy methods because it defines the involved locus in the brain, obviates the need for other time-consuming neurodiagnostic procedures, and provides 1-mm accuracy in reaching the desired biopsy site. Performed early in the clinical course, CT stereotaxic biopsy provides rapid histologic and virologic diagnosis and may eventually reduce the still unacceptably high mortality and morbidity associated with herpes simplex encephalitis.
AB - Four patients with suspected herpes simplex encephalitis underwent cerebral biopsies using a stereotaxic technique coupled with computed tomography (CT) scanning. Typical histopathologic features of viral encephalitis were identified on frozen section, allowing rapid introduction of systemic antiviral therapy. Herpes simplex virus was isolated from cultures from the brain within 24-48 hours. Despite antiviral therapy, three patients died and the fourth patient remains severely neurologically impaired. Treatment was started too late in the clinical course to be effective. To reduce the strikingly high mortality and morbidity associated with herpes simplex encephalitis, a biopsy must be performed as early as possible to confirm the diagnosis or to exclude other treatable conditions. Appropriate antiviral therapy must be predicated on a positive biopsy and instituted immediately after diagnosis. We prefer the CT stereotaxic technique to other biopsy methods because it defines the involved locus in the brain, obviates the need for other time-consuming neurodiagnostic procedures, and provides 1-mm accuracy in reaching the desired biopsy site. Performed early in the clinical course, CT stereotaxic biopsy provides rapid histologic and virologic diagnosis and may eventually reduce the still unacceptably high mortality and morbidity associated with herpes simplex encephalitis.
KW - Biopsy
KW - Computed tomography
KW - Diagnosis
KW - Herpes simplex encephalitis
KW - Stereotaxic technique
UR - http://www.scopus.com/inward/record.url?scp=0021345401&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0021345401&partnerID=8YFLogxK
U2 - 10.1016/0090-3019(84)90197-6
DO - 10.1016/0090-3019(84)90197-6
M3 - Article
C2 - 6420917
AN - SCOPUS:0021345401
VL - 21
SP - 249
EP - 257
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
IS - 3
ER -