PDF(Pubmed)
Abstract：
BACKGROUND: The occurrence of both an intracranial aneurysm and epilepsy, especially drug-resistant epilepsy (DRE), is rare. Although the overall incidence of aneurysms associated with DRE is unclear, it is thought to be particularly infrequent in the pediatric population. Surgical ligation of the offending aneurysm has been reported in conjunction with resolving seizure activity, although few cases have cited a combined approach of aneurysm ligation and resection of an epileptogenic focus.
METHODS: We present the case of a 14-year-old female patient with drug-resistant temporal lobe epilepsy and an ipsilateral supraclinoid internal carotid artery aneurysm. Seizure semiology, electroencephalography monitoring, and magnetic resonance imaging all indicated a left temporal epileptogenic focus, in addition to an incidental aneurysm. The authors recommended a combined surgery involving resection of the temporal lesion and surgical clip ligation of the aneurysm. Near-total resection and successful ligation were achieved, and the patient has remained seizure free since surgery at 1 year postoperatively.
CONCLUSIONS: In patients with focal DRE and an adjacent intracranial aneurysm, a combined surgical approach involving both resection and surgical ligation can be used. Several surgical timing and neuroanesthetic considerations should be made to ensure the overall safety and efficacy of this procedure.
METHODS: We present the case of a 14-year-old female patient with drug-resistant temporal lobe epilepsy and an ipsilateral supraclinoid internal carotid artery aneurysm. Seizure semiology, electroencephalography monitoring, and magnetic resonance imaging all indicated a left temporal epileptogenic focus, in addition to an incidental aneurysm. The authors recommended a combined surgery involving resection of the temporal lesion and surgical clip ligation of the aneurysm. Near-total resection and successful ligation were achieved, and the patient has remained seizure free since surgery at 1 year postoperatively.
CONCLUSIONS: In patients with focal DRE and an adjacent intracranial aneurysm, a combined surgical approach involving both resection and surgical ligation can be used. Several surgical timing and neuroanesthetic considerations should be made to ensure the overall safety and efficacy of this procedure.
摘要：
背景：颅内动脉瘤和癫痫的发生，尤其是耐药性癫痫（DRE），是罕见的。尽管与DRE相关的动脉瘤的总体发生率尚不清楚，这被认为是特别罕见的儿科人群。据报道，手术结扎动脉瘤与解决癫痫发作活动有关，尽管很少有病例提到动脉瘤结扎和切除癫痫灶的联合方法。
方法：我们介绍了一例14岁女性患者，患有耐药性颞叶癫痫和同侧颈内动脉瘤。癫痫发作符号学，脑电图监测，磁共振成像显示左侧颞叶癫痫灶,除了一个偶然的动脉瘤.作者建议进行联合手术，包括切除颞部病变和手术夹结扎动脉瘤。几乎完全切除并成功结扎，自术后1年手术以来，患者一直没有癫痫发作。
结论：在局灶性DRE和邻近颅内动脉瘤的患者中，可以使用包括切除和手术结扎的联合手术方法。应考虑一些手术时机和神经麻醉因素，以确保该手术的整体安全性和有效性。
方法：我们介绍了一例14岁女性患者，患有耐药性颞叶癫痫和同侧颈内动脉瘤。癫痫发作符号学，脑电图监测，磁共振成像显示左侧颞叶癫痫灶,除了一个偶然的动脉瘤.作者建议进行联合手术，包括切除颞部病变和手术夹结扎动脉瘤。几乎完全切除并成功结扎，自术后1年手术以来，患者一直没有癫痫发作。
结论：在局灶性DRE和邻近颅内动脉瘤的患者中，可以使用包括切除和手术结扎的联合手术方法。应考虑一些手术时机和神经麻醉因素，以确保该手术的整体安全性和有效性。
