Pasupula Venkataswamy
Herpes Simplex encephalitis is eminently treatable viral encephalitis which can rarely be complicated by a tumefactive inflammatory focus. The treatment strategy in this event should be aggressive to prevent immediate fatality as well as long term sequele. A 43-year-old woman with HSE developed new onset focal deficit with altered sensorium on the fourth day of illness despite early initiation of antiviral treatment. Imaging revealed right temporal and insular involvement with mass effect and midline shift. Decompressive craniectomy and temporal lobe biopsy was performed on emergent basis. The patient made remarkable clinical recovery subsequently. The report is presented for highlighting this rare complication as well as to reinstate the belief in surgical decompression as the preferred choice of treatment.
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