# Fulminant demyelinating disease of the central nervous system effectively treated with a combination of decompressive craniectomy and immunotherapy: A case report and literature review

## TL;DR

A rare brain disease was successfully treated with surgery and immunotherapy, leading to full recovery and no relapse for four years.

## Contribution

Demonstrates successful treatment of fulminant demyelinating disease using decompressive craniectomy and immunotherapy.

## Key findings

- A patient recovered fully after decompressive craniectomy and immunotherapy.
- The patient remained relapse-free for four years following treatment.
- Surgical intervention was effective when medical management failed.

## Abstract

Accurately identifying fulminant demyelinating diseases is important for sudden onset of asymmetric cerebral white matter lesions with mass effect. Initially, immunotherapy should be administered; however, surgical intervention should be performed with poor response to medical management and evident signs of cerebral herniation.

A case of fulminant demyelinating disease of the central nervous system that required decompressive craniectomy 8 days after symptom onset is presented. The patient recovered without sequelae after a combination of neurosurgery and immunotherapy with steroids and has remained relapse‐free for 4 years.