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Diffuse vasospasm after transcortical temporal lobectomy for intractable epilepsy

  • Case Report - Functional Neurosurgery - Epilepsy
  • Published:
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Abstract

Cerebral delayed ischemia due to arterial vasospasm is a rare complication following epilepsy surgery. Here we report the third known case and first of diffuse vasospasm. A 48-year-old woman underwent a transcortical anterior left temporal lobectomy. Eleven days later, she had new-onset expressive aphasia with narrowing of the anterior, middle, and posterior cerebral arteries, and increased velocities via transcranial Doppler. She was treated with fluids, nimodipine, and permissive hypertension. At 6 months, her speech was near baseline. Cerebral vasospasm may represent a rare cause of morbidity after anterior temporal lobectomy; a literature review on the subject is presented.

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Abbreviations

SAH:

Subarachnoid hemorrhage

MRI:

Magnetic resonance imaging

PET:

Positron emission tomography

NSICU:

Neuroscience intensive care unit

CT:

Computed tomography

POD:

Post-operative day

MCA:

Middle cerebral artery

CTA:

Computed tomography angiography

ICA:

Internal carotid artery

ACA:

Anterior cerebral artery

IV:

Intravenous

CSF:

Cerebrospinal fluid

References

  1. Aoki N, Origitano TC, al-Mefty O (1995) Vasospasm after resection of skull base tumors. Acta Neurochir 132(1–3):53–58 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/7754859

    Article  PubMed  CAS  Google Scholar 

  2. Chaichana K, Riley LH, Tamargo RJ (2007) Delayed cerebral vasospasm secondary to bacterial meningitis after lumbosacral spinal surgery: case report. Neurosurgery 60(1):E206–E207. https://doi.org/10.1227/01.NEU.0000249193.68904.B4

    Article  PubMed  Google Scholar 

  3. Chakravarty A, Anand S (2015) Cerebral vasospasm after selective amygdalohippocampectomy. Indian J Anaesth 59(6):380–382. https://doi.org/10.4103/0019-5049.158763

    Article  PubMed  PubMed Central  Google Scholar 

  4. Claassen J, Bernardini GL, Kreiter K, Bates J, Du YE, Copeland D et al (2001) Effect of cisternal and ventricular blood on risk of delayed cerebral ischemia after subarachnoid hemorrhage: the fisher scale revisited. Stroke 32(9):2012–2020 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11546890

    Article  PubMed  CAS  Google Scholar 

  5. Fassbender K, Ries S, Schminke U, Schneider S, Hennerici M (1996) Inflammatory cytokines in CSF in bacterial meningitis: association with altered blood flow velocities in basal cerebral arteries. J Neurol Neurosurg Psychiatry 61(1):57–61 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8676162

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Frontera JA, Claassen J, Schmidt JM, Wartenberg KE, Temes R, Connolly ES et al (2006) Prediction of symptomatic vasospasm after subarachnoid hemorrhage: the modified fisher scale. Neurosurgery 59(1):21–27. https://doi.org/10.1227/01.NEU.0000218821.34014.1B

    Article  PubMed  Google Scholar 

  7. Goodman RR (2013) Cerebral vasospasm after temporal lobe epilepsy surgery: clinically important? Epilepsy Currents 13(2):69–70. https://doi.org/10.5698/1535-7597-13.2.69

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hansen-Schwartz J (2004) Cerebral vasospasm: a consideration of the various cellular mechanisms involved in the pathophysiology. Neurocrit Care 1(2):235–246. https://doi.org/10.1385/NCC:1:2:235

    Article  PubMed  CAS  Google Scholar 

  9. Kassell NF, Sasaki T, Colohan AR, Nazar G (1985) Cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Stroke 16(4):562–572 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/3895589

    Article  PubMed  CAS  Google Scholar 

  10. Lackner P, Koppelstaetter F, Ploner P, Sojer M, Dobesberger J, Walser G, Schmutzhard E, Schmidauer C, Bauer R, Unterberger I, Ortler M, Trinka E (2012) Cerebral vasospasm following temporal lobe epilepsy surgery. Neurology 78(16):1215–1220. https://doi.org/10.1212/WNL.0b013e318250d7d6

    Article  PubMed  CAS  Google Scholar 

  11. Maeda K, Kurita H, Nakamura T, Usui M, Tsutsumi K, Morimoto T, Kirino T (1997) Occurrence of severe vasospasm following intraventricular hemorrhage from an arteriovenous malformation. J Neurosurg 87(3):436–439. https://doi.org/10.3171/jns.1997.87.3.0436

    Article  PubMed  CAS  Google Scholar 

  12. Mandonnet E, Chassoux F, Naggara O, Roux FX, Devaux B (2009) Transient symptomatic vasospasm following antero-mesial temporal lobectomy for refractory epilepsy. Acta Neurochir 151(12):1723–1726. https://doi.org/10.1007/s00701-009-0314-5

    Article  PubMed  CAS  Google Scholar 

  13. Martin NA, Doberstein C, Alexander M, Khanna R, Benalcazar H, Alsina G et al (1995) Posttraumatic cerebral arterial spasm. J Neurotrauma 12(5):897–901. https://doi.org/10.1089/neu.1995.12.897

    Article  PubMed  CAS  Google Scholar 

  14. O’Brien TJ, Cascino GD (2012) Should patients be routinely assessed for cerebral vasospasm after temporal lobe epilepsy surgery? Neurology 78(16):1196–1197. https://doi.org/10.1212/WNL.0b013e318250d85b

    Article  PubMed  Google Scholar 

  15. Oertel M, Boscardin WJ, Obrist WD, Glenn TC, McArthur DL, Gravori T, Lee JH, Martin NA (2005) Posttraumatic vasospasm: the epidemiology, severity, and time course of an underestimated phenomenon: a prospective study performed in 299 patients. J Neurosurg 103(5):812–824. https://doi.org/10.3171/jns.2005.103.5.0812

    Article  PubMed  Google Scholar 

  16. Ross D, Rosegay H, Pons V (1988) Differentiation of aseptic and bacterial meningitis in postoperative neurosurgical patients. J Neurosurg 69(5):669–674. https://doi.org/10.3171/jns.1988.69.5.0669

    Article  PubMed  CAS  Google Scholar 

  17. Schaller C, Zentner J (1998) Vasospastic reactions in response to the transsylvian approach. Surg Neurol 49(2):170–175 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9457267

    Article  PubMed  CAS  Google Scholar 

  18. Schaller C, Klemm E, Haun D, Schramm J, Meyer B (2002) The transsylvian approach is “minimally invasive”; but not “atraumatic”. Neurosurgery 51(4):971–976 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12234405

    PubMed  Google Scholar 

  19. Schaller C, Jung A, Clusmann H, Schramm J, Meyer B (2004) Rate of vasospasm following the transsylvian versus transcortical approach for selective amygdalohippocampectomy. Neurol Res 26(6):666–670. https://doi.org/10.1179/016164104225015921

    Article  PubMed  Google Scholar 

  20. Wang K-W, Chang W-N, Huang C-R, Tsai N-W, Tsui H-W, Wang H-C et al (2005) Post-neurosurgical nosocomial bacterial meningitis in adults: microbiology, clinical features, and outcomes. J Clin Neurosci 12(6):647–650. https://doi.org/10.1016/j.jocn.2004.09.017

    Article  PubMed  Google Scholar 

  21. Weir B, Grace M, Hansen J, Rothberg C (1978) Time course of vasospasm in man. J Neurosurg 48(2):173–178. https://doi.org/10.3171/jns.1978.48.2.0173

    Article  PubMed  CAS  Google Scholar 

  22. Zhu T, Yao Z, Yuan H, Lu B, Yang S (2004) Changes of interleukin-1 beta, tumor necrosis factor alpha and interleukin-6 in brain and plasma after brain injury in rats. Chin J Traumatol 7(1):32–35 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14728816

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA

    James Charles Dickerson, Joaquin Andres Hidalgo, Zachary Stidham Smalley & James Mason Shiflett

Authors
  1. James Charles Dickerson
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  2. Joaquin Andres Hidalgo
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  3. Zachary Stidham Smalley
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  4. James Mason Shiflett
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Correspondence to James Charles Dickerson.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human or animal participants performed by any of the authors.

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The patient consented for the use of their case in scholarly activities, such as education and research.

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This work has not been previously presented at any conference or published elsewhere.

There was no clinical trial registration number for this work.

This article is part of the Topical Collection on Functional Neurosurgery–Epilepsy

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Dickerson, J.C., Hidalgo, J.A., Smalley, Z.S. et al. Diffuse vasospasm after transcortical temporal lobectomy for intractable epilepsy. Acta Neurochir 160, 1883–1887 (2018). https://doi.org/10.1007/s00701-018-3606-9

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  • DOI: https://doi.org/10.1007/s00701-018-3606-9

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