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Diffuse vasospasm after transcortical temporal lobectomy for intractable epilepsy

  • James Charles Dickerson
  • Joaquin Andres Hidalgo
  • Zachary Stidham Smalley
  • James Mason Shiflett
Case Report - Functional Neurosurgery - Epilepsy
  • 19 Downloads
Part of the following topical collections:
  1. Functional Neurosurgery – Epilepsy

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.

Keywords

Epilepsy Neurosurgery Epilepsy surgery Vasospasm Diffuse Triple H Amygdalohippocampectomy Temporal lobe resection Transsylvian Transcortical 

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

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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

Patient consent

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

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryUniversity of Mississippi Medical CenterJacksonUSA

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