Burn-induced neuroepithelial changes as a delayed cause of mortality in major burns: a case report and literature review

International Journal of Burns and Trauma

Dana A Obeid¹  Abdulaziz K Alhujayri²  Salah Aldekhayel³ 

[1] College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;Division of Plastic Surgery, Department of Surgery, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia;King Abdullah International Medical Research Center, Riyadh, Saudi Arabia

关键词: Burn;    brain tumors;    glioma;    mortality;    neuropathology;    immunosuppression;   

DOI  :  

学科分类：外科医学

来源: e-Century Publishing Corporation

【 摘 要 】

Background: Mortality in major burns is caused mainly by multisystem organ failure. Brain lesions in burn patients are rare and predominantly traumatic in nature. Here, we present an unusual case of burn-induced glioma causing rapid neurological deterioration and death. Case presentation: A 33-year-old male, with 85% total body surface area (TBSA) flame burns, presented initially with inhalation injury and acute compartment syndrome with no other associated injuries. Based on the initial assessment, the patient’s cognitive status was not affected, with a Glasgow coma scale (GCS) on admission of 15/15 and normal brain computed tomography (CT) images. The patient was resuscitated and immediately admitted to the burns unit where he underwent multiple sessions of debridement and skin grafting. The patient’s neurological status deteriorated dramatically, and brain magnetic resonance imaging (MRI) confirmed the presence of a heterogenous mass, highly suggestive of a high-grade glioma, that was not present during the initial assessment. Unfortunately, the patient died shortly afterwards as a result of cardiac asystole. Conclusions: Multiple studies have demonstrated a connection between chronic inflammatory processes and gliomagenesis. The case presented here supports the notion that high-grade gliomas can progress rapidly in immunocompromised patients, thus further reducing survival rates. Therefore, patients with inflammatory conditions combined with neurological symptoms/signs should be investigated thoroughly to evaluate the presence and extent of such pathology. Newly developed radiological modalities can help in early detection and timely management of the condition.

【 授权许可】

CC BY-NC