J Neurosurg Case Lessons. 2025 Dec 1;10(22):CASE25209. doi: 10.3171/CASE25209. Print 2025 Dec 1.
ABSTRACT
BACKGROUND: Two cases detailing the management of intracranial hypertension via a lumbar drain (LD) in both autoimmune and infectious encephalitis are reported.
OBSERVATIONS: Intracranial hypertension was noted with both etiologies, which improved with immediate and continuous CSF drainage with a diversion device. Treatment of elevated intracranial pressures correlated with symptom control. With multimodal management, both patients demonstrated clinical improvement and intracranial hypertension resolution without the need for a permanent diversion device. After discharge, both patients exhibited near neurological recovery.
LESSONS: Use of an LD has been documented and studied in primarily adult patients with acute bacterial meningitis. However, several small case studies and series have shown safety and utility of CSF diversion in encephalitis. Meningoencephalitis is associated with intracranial hypertension, which may be managed with temporary CSF diversion. https://thejns.org/doi/10.3171/CASE25209.
PMID:41343782 | DOI:10.3171/CASE25209
