Open AccessBurden of dengue-related neurosurgical emergencies during an epidemic: A tertiary care experience
Author(s) -
Raja K Kutty,
Sunilkumar Balakrishnan Sreemathyamma,
Jyothish Laila Sivanandapanicker,
Vijay Mundhe,
Kapil Chhabra,
Anilkumar Peethambaran
Publication year - 2019
Publication title -
asian journal of neurosurgery
Language(s) - English
Resource type - Journals
ISSN - 2248-9614
DOI - 10.4103/ajns.ajns_318_17
Subject(s) - medicine , dengue fever , coagulopathy , dengue virus , hematoma , encephalopathy , neurosurgery , surgery , pediatrics , consumptive coagulopathy , virology
Dengue is one of the most common flavivirus infections which can manifest from common flu-like fever to fatal hemorrhagic complication. Epidemics of dengue return every year with peaks during the rainfall claiming substantial number of lives in the tropical and subtropical regions of the world. We present manifestations of dengue in patients who underwent neurosurgery in a tertiary referral center during such an epidemic. There were total four patients referred for neurosurgical intervention as sequelae to dengue coagulopathy. Among them, three had intracranial bleeds and one had spinal cord hematoma along with intracranial hemorrhages. This small series includes the youngest reported case of dengue coagulopathy with intracranial bleed and only the second case of spontaneous intraspinal hematoma sequelae to dengue hemorrhagic fever. The situations where patients contract dengue in a setting of neurosurgical intervention are grave. The margin of safety in the presence of dengue coagulopathy is narrow. The surgeon has to outweigh benefit against risk of surgery in each individual.