Unruptured Posterior Cerebral Artery Aneurysm Presenting with Temporal Lobe Epilepsy

Yefet, Leeor S; Fatehi, Mostafa; Aghakhani, Yahya; Redekop, Gary

doi:10.1017/cjn.2020.105

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…[2][3][4][5][6][7] Although uncommon, unruptured intracranial aneurysms have been associated with seizures in select cases. Some postulate that cortical excitability secondary to mass effect and/or recurrent microhemorrhages may explain this occurrence, 8,9 while others suggest that a correlation between ipsilateral aneurysms and seizures may exist. 10,11 Despite these hypotheses, intracranial aneurysms remain invariably rare among pediatric patients, accounting for less than 5% of all cases treated at neurovascular centers, 12,13 and comprise an even smaller subpopulation of pediatric patients with epilepsy.…”

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confidence: 99%

Focal drug-resistant temporal lobe epilepsy associated with an ipsilateral anterior choroidal artery aneurysm: illustrative case

Phillips¹,

Rangwala²,

Papadakis³

et al. 2023

Journal of Neurosurgery: Case Lessons

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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. OBSERVATIONS 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. LESSONS 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.

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