HERPES-SIMPLEX ENCEPHALITIS AND BILATERAL ACUTE RETINAL NECROSIS SYNDROME AFTER CRANIOTOMY

PURPOSE: Acute retinal necrosis (ARN) syndrome is associated with memb ers of the herpes virus family, but the mechanisms of infection remain unclear. The purpose of this study is to report a unique case of acut e retinal necrosis syndrome associated with herpetic encephalitis in o rder to elucidate possible factors involved in herpetic central nervou s system disease. METHOD: Case report. RESULTS: A 64-year-old woman wh o developed acute herpes simplex virus encephalitis associated with bi lateral acute retinal necrosis syndrome after craniotomy for resection of a suprasellar craniopharyngioma is presented. The results of lumba r puncture, magnetic resonance imaging, and ophthalmologic examination are consistent with herpetic infection. The origin of acute retinal n ecrosis syndrome and the association of acute retinal necrosis syndrom e with encephalitis are reviewed. CONCLUSIONS: After craniotomy, we hy pothesize reactivation of previously latent herpes simplex virus in th e area of the inferior frontal lobe and optic chiasm. Reactivated viru s may have migrated to the retina by axonal transport, through the opt ic nerves, to produce the acute retinal necrosis syndrome. (C) 1998 by Elsevier Science Inc. All rights reserved.