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Related Experiment Video

Updated: Jun 27, 2026

Stereo-Electro-Encephalo-Graphy SEEG With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note
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Pseudoaneurysm Formation after Stereoencephalography for Epilepsy.

Henry M Skelton1,2, Nealen G Laxpati1, Jason J Lamanna1

  • 1Department of Neurosurgery, Emory School of Medicine, Atlanta, Georgia, USA.

Stereotactic and Functional Neurosurgery
|February 9, 2025
PubMed
Summary

Stereoencephalography (SEEG) can lead to rare pseudoaneurysms, a vascular complication that may be underdiagnosed due to delayed formation. Further imaging surveillance may be prudent to detect these potentially devastating, yet treatable, post-procedural events.

Keywords:
ComplicationsDepth electrodesHemorrhageStereoencephalographyStereotactic surgery

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Area of Science:

  • Neurosurgery
  • Neurology
  • Vascular Surgery

Background:

  • Stereoencephalography (SEEG) is the standard for epilepsy surgery preoperative evaluation.
  • Intracranial implants, including SEEG, carry a risk of vascular injury and pseudoaneurysm formation.
  • Delayed hemorrhage from pseudoaneurysms post-SEEG is rare and its cause is unclear.

Observation:

  • A patient undergoing two SEEG implantations for drug-resistant epilepsy developed a pseudoaneurysm near an SEEG site.
  • The pseudoaneurysm was identified on preoperative imaging for deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT).
  • The patient's pseudoaneurysm was successfully treated with excision and vascular bypass prior to DBS.

Findings:

  • Retrospective analysis suggests SEEG implantation caused the pseudoaneurysm, likely due to arterial collision from trajectory deviation.
  • Delayed pseudoaneurysm formation may lead to underdiagnosis on routine postoperative imaging.
  • Pseudoaneurysm is a potentially underrecognized complication of SEEG.

Implications:

  • Increased vigilance and radiological surveillance may be warranted after SEEG procedures.
  • Early recognition and treatment of post-SEEG pseudoaneurysms are crucial to prevent severe complications.
  • This complication, though serious, does not necessarily preclude subsequent epilepsy surgery.