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Cerebral vasospasm following temporal lobe epilepsy surgery
P Lackner1, F Koppelstaetter, P Ploner
1Department of Neurology, Innsbruck Medical University, Innsbruck, Austria. peter.lackner@i-med.ac.at
Neurology
|March 24, 2012
Summary
Cerebral vasospasm (CVS) frequently complicates temporal lobe epilepsy surgery, occurring in 32.7% of patients. Female gender and increased bleeding volume are key risk factors, leading to prolonged hospital stays.
Area of Science:
- Neurosurgery
- Neurology
- Vascular Neurology
Background:
- Selective amygdalohippocampectomy (AHE) is linked to postoperative cerebral vasospasm (CVS) in epilepsy patients.
- The incidence of CVS following temporal lobe resection (TLR) is not well-established.
Purpose of the Study:
- To determine the incidence of CVS after TLR and AHE.
- To identify risk factors associated with CVS development in these patients.
Main Methods:
- Retrospective cohort study of 119 patients undergoing TLR or AHE between 1998 and 2009.
- Preoperative and postoperative transcranial Doppler sonography (TCD) and neurologic examinations were performed.
- Postoperative CT scans were analyzed for bleeding volume.
Main Results:
- 32.7% of 107 patients with TCD data developed postoperative CVS.
- CVS incidence did not differ between TLR and AHE groups.
- Female gender and higher postoperative bleeding volume were significant risk factors for CVS.
- CVS was associated with increased postoperative neurologic symptoms and prolonged hospital stay.
Conclusions:
- CVS is a common complication of temporal lobe epilepsy surgery, regardless of resection type.
- Female sex and greater surgical bleeding increase CVS risk.
- CVS negatively impacts patient outcomes, causing more frequent neurologic deficits and longer hospitalizations.
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