Surgical neurology 2009-Nov
Reactivation and centripetal spread of herpes simplex virus complicating acoustic neuroma resection.
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BACKGROUND
Herpes simplex is a common human pathogen that has rare but severe manifestations including encephalitis.
METHODS
A 44-year-old man underwent uneventful resection of an acoustic neuroma. Postoperatively, he developed swinging pyrexia, vomiting, and episodic confusion. Analysis of cerebrospinal fluid showed a lymphocytosis, and polymerase chain reaction revealed herpes simplex DNA. After treatment of herpes encephalitis with acyclovir, the patient made a good recovery.
CONCLUSIONS
Herpes encephalitis is a rare complication of neurosurgical procedures, and the most likely etiology is reactivation of latent infection from manipulation of cranial nerves.
