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

Mandonnet, E; Chassoux, F; Naggara, O; Roux, F X; Devaux, B · Acta Neurochir (Wien) · 2009

case_report · Level V

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Abstract

Arterial vasospasm has rarely been reported following temporal lobectomy for intractable epilepsy. 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. Transient vasospasm is a likely underestimated cause of focal deficit following temporomesial resection that deserves appropriate treatment.

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