Focal drug-resistant temporal lobe epilepsy associated with an ipsilateral anterior choroidal artery aneurysm: illustrative case.
| Autor: | Phillips HW; Departments of1Neurosurgery., Rangwala SD; Departments of1Neurosurgery., Papadakis J; Departments of1Neurosurgery., Segar DJ; Departments of1Neurosurgery., Tsuboyama M; 2Neurology, and., Pinto ALR; 2Neurology, and., Harmon JP; 3Division of Neurology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah., Soriano SG; 4Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; and., Munoz CJ; 4Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; and., Madsen JR; Departments of1Neurosurgery., See AP; Departments of1Neurosurgery., Stone SS; Departments of1Neurosurgery. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2023 Jun 26; Vol. 5 (26). Date of Electronic Publication: 2023 Jun 26 (Print Publication: 2023). |
| DOI: | 10.3171/CASE23156 |
| Abstrakt: | Background: The occurrence of both an intracranial aneurysm and epilepsy, especially drug-resistant epilepsy (DRE), is rare. Although the overall incidence of aneurysms associated with DRE is unclear, it is thought to be particularly infrequent in the pediatric population. Surgical ligation of the offending aneurysm has been reported in conjunction with resolving seizure activity, although few cases have cited a combined approach of aneurysm ligation and resection of an epileptogenic focus. Observations: We present the case of a 14-year-old female patient with drug-resistant temporal lobe epilepsy and an ipsilateral supraclinoid internal carotid artery aneurysm. Seizure semiology, electroencephalography monitoring, and magnetic resonance imaging all indicated a left temporal epileptogenic focus, in addition to an incidental aneurysm. The authors recommended a combined surgery involving resection of the temporal lesion and surgical clip ligation of the aneurysm. Near-total resection and successful ligation were achieved, and the patient has remained seizure free since surgery at 1 year postoperatively. Lessons: In patients with focal DRE and an adjacent intracranial aneurysm, a combined surgical approach involving both resection and surgical ligation can be used. Several surgical timing and neuroanesthetic considerations should be made to ensure the overall safety and efficacy of this procedure. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|