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[Temporal lobectomy in cerebral infarction with mass effect]
L F Martins1, V Da Costa, J Da Costa
1Instituto de Neurologia de Goiânia, Brasil.
Arquivos De Neuro-Psiquiatria
|March 1, 1993
Summary
Temporal lobectomy can be life-saving for ischemic stroke patients with brain herniation. This surgical decompression offers a chance for survival when medical management fails, especially with early intervention.
Area of Science:
- Neurosurgery
- Neurology
- Critical Care Medicine
Background:
- Cerebral edema following ischemic stroke poses a significant mortality risk, often refractory to medical interventions.
- Early detection of impending temporal lobe herniation is possible through clinical assessment and CT imaging.
Observation:
- Eight patients (4 male, 4 female; ages 48-74) with ischemic stroke and signs of imminent herniation underwent temporal lobectomy.
- The surgical procedure followed the standard technique described by Olivier for temporal lobe epilepsy.
Findings:
- Six patients survived the temporal lobectomy, indicating a potential benefit of the surgical approach.
- Two patients died, likely due to the procedure being indicated too late in their clinical course.
Implications:
- Temporal lobectomy can be a life-saving intervention for ischemic stroke patients experiencing significant mass effect and brainstem compression.
- Timely surgical intervention is crucial for improving outcomes in cases of large ischemic cerebral infarction with herniation risk.