TEMPORAL LOBE CYST AND HIGROMA AS COMPLICATIONS AFTER CORTICO-AMYGDALO-HIPPOCAMPECTOMY FOR TREATMENT OF REFRACTORY TEMPORAL LOBE EPILEPSY
Abstract number :
1.425
Submission category :
Year :
2004
Submission ID :
4453
Source :
www.aesnet.org
Presentation date :
12/2/2004 12:00:00 AM
Published date :
Dec 1, 2004, 06:00 AM
Authors :
1,2Jose A. Burattini, 1,2Arthur Cukiert, 1,2Pedro P. Mariani, 1Lauro Ceda, 1Rodio Brandao, 1,2Cristine M. Baldauf, 1,2Carla Baise-Zung, 1,2Meire Argentoni, 1,2
Cortico-amygdalo-hippocampectomy (CAH, including all technical variants) is the most commonly performed surgical procedure for treatment of refractory epilepsy. Complications might occur in 1% of the patients and include hemathoma and ischemic or venous infarcts, leading to variable neurologic morbidity or death. This paper reports on the occurrence of higroma and temporal lobe cyst after CAH. This association has not been reported previously in the literature and occurred once in more then 400 CAHs performed in our center. A 21-years old man with refractory temporal lobe epilepsy related to MR documented left mesial temporal sclerosis was studied. He has had febrile seizures during infancy. He had refractory epigastric simple and complex partial seizures with bimanual automatisms. There was no history of brain infection or any other specific event. He was submitted to CAH; the procedure was uneventful. The patient has been seizure[acute]s-free since surgery. Three weeks after CAH, he presented with grade-IV hemiparesis. CT showed a volumous anterior temporal lobe cyst and temporo-parietal higroma; he was submitted to higroma-peritoneal shunting, with the disappearance of hemiparesis. One month afterwards, hemiparesis reappeared. TC showed disappearance of higroma and increase in the size of the anterior temporal lobe cyst. He was submitted to surgical degloving of the cyst and ample communication with the basal cisterns was created. He has been asymptomatic since the latter. Postoperative cerebrospinal fluid dynamics disturbances are rare after CAH. Treatment might include shunting (when higroma is present) or degloving (when an isolated cyst is present), or both. (Supported by Sao Paulo[apos]s Secretary of Health)