Revista médica de Chile
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Revista médica de Chile · Dec 2003
Case Reports[Decompressive craniectomy in a patient with herpetic encephalitis associated to refractory intracranial hypertension].
Herpetic encephalitis is the most common cause of viral encephalitis in our country. Pathological studies show progressive necrosis and edema in specific territories of the brain. The mortality of herpetic encephalitis was reduced from 70% to 20% with the use of intravenous aciclovir in the first three days of illness. ⋯ One of the most important causes of death in herpetic encephalitis is the refractory intracranial hypertension. There are anecdotal reports of patients with refractory intracranial hypertension due to herpetic encephalitis that were treated with decompressive craniectomy with good results. We report a 21 years old female patient with herpetic encephalitis and refractory intracranial hypertension that was successfully treated with a decompressive craniectomy.
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Conflicts of interest are frequent in medical practice. They occur when a secondary interest unduly influences professional medical judgment, over and above the patients' benefit, his first real interest. Most of these secondary interests come from particular businesses of the physicians or their relationships with the industry. ⋯ These conflicts of interest vary in types and magnitude and are not recognized by physicians on most occasions. Solutions are inevitably related to the honesty and integrity of each physician. Due to the absence of specific national ethical references, it is necessary to discuss the issue and conclude recommendations that guide interns, residents, clinicians, researchers, medical educators, medical and scientific associations to resolve these types of conflicts.