Postoperative Herpes Viral Infections in Neurosurgery – An Experience and Arguments for and against the Plausible Hypotheses

Author:

Kumar Sanjeev1,Sahana Debabrata1,Rathore Lavlesh1,Jain Amit1,Borde Praveen1,Tawari Manish1,Sahu Rajiv1

Affiliation:

1. Department of Neurosurgery, DKS Post Graduate Institute and Research Center, Raipur, Chhattisgarh, India

Abstract

Background: The literature contains several reports of herpes recrudescence after neurosurgery. We analyze our experience by vindicating or refuting the existing plausible hypotheses. Material and Methods: This is a retrospective review of all neurosurgical cases that developed postoperative herpes infection between January 2016 and June 2020. Results: Six patients developed herpes infection after vestibular schwannoma (VS) surgery. Other neurosurgical cases did not develop herpes infection. There were five females and one male, with a mean age of 44.1 years. Four out of six patients developed delayed facial palsy (DFP) and did not improve after antiviral treatment. Postoperative herpes infections were 0.2% among all operated patients, 3.07% among all cerebellopontine (CP) angle surgeries, and 5.6% among VS surgeries. Conclusions: To date, none of the plausible hypotheses satisfactorily addresses all aspects of viral recrudescence. The etiology may be multi-factorial, and in all cases of unexplained clinical deterioration, herpes infection needs consideration in the differential diagnosis.

Publisher

Medknow

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