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Transient symptomatic vasospasm following antero-mesial temporal lobectomy for refractory epilepsy

  • Case Report
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Abstract

Rationale

Arterial vasospasm has rarely been reported following temporal lobectomy for intractable epilepsy.

Case presentation

A 31-year-old patient presented with a global aphasia 2 days after a left dominant anteromesial temporal lobectomy for intractable epilepsy. Magnetic resonance imaging on 5th post-operative day revealed severe narrowing of M1 segment of the left middle cerebral artery (MCA) and Transcranial Doppler (TCD) ultrasonography an increased velocity of the MCA that suggested a severe vasospasm. The patient received continuous intravenous hyperhydratation and nimodipine; aphasia improved within 24 h and resolved completely within 6 weeks, associated with velocity reduction on control TCD.

Conclusion

Transient vasospasm is a likely underestimated cause of focal deficit following temporomesial resection that deserves appropriate treatment.

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Authors and Affiliations

  1. Departments of Neurosurgery (EM, FC,FXR, BD) and Neuroradiology (ON), Centre Hospitalier Sainte-Anne, Paris, France

    E. Mandonnet, F. Chassoux, O. Naggara, F. X. Roux & B. Devaux

  2. Service de Neurochirurgie, Hôpital Sainte-Anne, 1 rue Cabanis, 75674, Paris Cedex 14, France

    B. Devaux

Authors
  1. E. Mandonnet
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  2. F. Chassoux
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  3. O. Naggara
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  4. F. X. Roux
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  5. B. Devaux
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Corresponding author

Correspondence to B. Devaux.

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Comments

This interesting case report reminds us that even the most uneventful surgical procedure can lead to a postoperative complication. A point of interest is that TCD should be part of the work up in case of unexpected postoperative neurological deficits.

Mario Zuccarello

Mayfield Clinic, USA

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

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  • DOI: https://doi.org/10.1007/s00701-009-0314-5

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