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Updated: May 10, 2026
Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
Complications after mesial temporal lobe surgery via inferiortemporal gyrus approach
Fernando L Vale1, Stephen Reintjes, Hermes G Garcia
1Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL 33606, USA. fvale@health.usf.edu
Object:
The purpose of this study was to identify the complications associated with the inferior temporal gyrus approach to anterior mesial temporal lobe resection for temporal lobe epilepsy.
Methods:
This retrospective study examined complications experienced by 483 patients during the 3 months after surgery. All surgeries were performed during 1998-2012 by the senior author (F.L.V.).
Results:
A total of 13 complications (2.7%) were reported. Complications were 8 delayed subdural hematomas (1.6%), 2 superficial wound infections (0.4%), 1 delayed intracranial hemorrhage (0.2%), 1 small lacunar stroke (0.2%), and 1 transient frontalis nerve palsy (0.2%). Three patients with subdural hematoma (0.6%) required readmission and surgical intervention. One patient (0.2%) with delayed intracranial hemorrhage required readmission to the neuroscience intensive care unit for observation. No deaths or severe neurological impairments were reported. Among the 8 patients with subdural hematoma, 7 were older than 40 years (87.5%); however, this finding was not statistically significant (p = 0.198).
Conclusions:
The inferior temporal gyrus approach to mesial temporal lobe resection is a safe and effective method for treating temporal lobe epilepsy. Morbidity and mortality rates associated with this procedure are lower than those associated with other neurosurgical procedures. The finding that surgical complications seem to be more common among older patients emphasizes the need for early surgical referral of patients with medically refractory epilepsy.
Insights
The inferior temporal gyrus approach for temporal lobe epilepsy surgery is safe, with a low complication rate of 2.7%. Older patients may face slightly higher risks, highlighting the need for timely surgical referral.
Area of Science:
- Neurosurgery
- Epileptology
Background:
- Temporal lobe epilepsy (TLE) is a common neurological disorder.
- Mesial temporal lobe resection (MTLR) is a key surgical treatment for TLE.
- The inferior temporal gyrus (ITG) approach offers an alternative surgical pathway for MTLR.
Purpose of the Study:
- To identify and analyze complications associated with the ITG approach for anterior MTLR in TLE patients.
- To evaluate the safety and efficacy of the ITG approach for TLE surgery.
Main Methods:
- Retrospective analysis of 483 patients undergoing ITG approach for anterior MTLR.
- Data collected on complications within 3 months post-surgery.
- Surgeries performed between 1998 and 2012 by a single senior surgeon.
Main Results:
- A total of 13 complications (2.7%) were reported.
- Most common complications included delayed subdural hematomas (1.6%) and superficial wound infections (0.4%).
- No deaths or severe neurological impairments occurred; some patients required readmission for management of hematomas.
Conclusions:
- The ITG approach for anterior MTLR is a safe and effective treatment for TLE.
- Complication and mortality rates are low compared to other neurosurgical procedures.
- The tendency for increased complications in older patients underscores the importance of early surgical referral for medically refractory TLE.
