A possible case of unruptured middle cerebral artery aneurysm presenting as epileptic seizures

Zambrelli, Elena; Cavallini, Anna; Tosi, Piera; Marcheselli, Simona; Giardini, Guido; Pichiecchio, Anna; Micieli, Giuseppe

doi:10.1007/s10072-003-0101-7

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…53 Conversely, one should keep in mind that unruptured aneurysms, especially of the middle cerebral artery, may rarely present with seizures. [58][59][60] Prophylactic antiepileptic treatment is not advocated by all experts. In a retrospective study, Rhoney et al 61 argued that seizures were unpreventable, because most occurred during the prehospital period, and seizures after admission were not prevented in 75% by antiepileptics.…”

Section: Seizures After Subarachnoid Hemorrhagementioning

confidence: 99%

Management of Seizures in the Critically Ill

Varelas¹,

Spanaki²

2006

The Neurologist

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Seizures in a critically ill patient are not infrequent phenomena. Physicians are perplexed by the wide range of possible cranial or extracranial etiologies, alerted by the risk for further crucial organ compromise if seizures recur, and confused about the treatment options in an environment rich in complex drug interactions and multiple organ dysfunction. The advent of an armamentarium containing multiple new antiepileptic medications complicates the situation further, since several of them have less known mechanisms of action, side effects, or interactions with other intensive care unit (ICU) medications. This review contains useful information regarding the most common etiologies and treatment options for intensivists, consulting neurologists, neurosurgeons, or other specialized physicians treating ICU patients with seizures.

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Section: Seizures After Subarachnoid Hemorrhagementioning

confidence: 99%

Management of Seizures in the Critically Ill

Varelas¹,

Spanaki²

2006

The Neurologist

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“…27) Based on intraoperative observations, the epilepsy was attributed to gliosis around the aneurysm via subclinical hemorrhages in the MCA case and local compression of the temporal lobe by the aneurysm in the IC-PC case. 27) Complex partial seizures due to temporal lobe compression and injury occur more commonly in patients with large or giant MCA aneurysms, 92,98,105) possibly due to the lower threshold for epilepsy in the injured mesial temporal lobe. A case of complex partial seizures was associated with an unruptured thrombosed basilar tip aneurysm.…”

Section: Unruptured Cerebral Aneurysms Causing Epilepsymentioning

confidence: 99%

“…61) Epilepsy often disappears after clipping of the Symptomatic Unruptured Cerebral Aneurysms aneurysm, 27,98) and anti-epileptic medication can control residual seizure activity. 61,92,105) Four cases of giant MCA aneurysms caused epilepsy by compression and ischemia of the temporal lobe; 2 cases treated by successful clipping demonstrated disappearance of the epilepsy and 2 cases treated by wrapping only continued to show epilepsy after surgery. 98) An MCA aneurysm facing the left superior temporal gyrus caused complex partial seizures, which disappeared after coil embolization due to reduced pulsation of the aneurysm after the embolization.…”

Section: Unruptured Cerebral Aneurysms Causing Epilepsymentioning

confidence: 99%

Symptomatic Unruptured Cerebral Aneurysms: Features and Surgical Outcome

Date

2010

Neurol. Med. Chir.(Tokyo)

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Development of less invasive imaging studies, such as magnetic resonance angiography, has increased the chances that unruptured cerebral aneurysms are found. The rupture risk of``symptomatic'' aneurysms is higher than for``asymptomatic'' aneurysms; so``symptomatic'' aneurysms are more often surgically treated. Many reviews examine``asymptomatic'' unruptured cerebral aneurysms, but few evaluate``symptomatic'' aneurysms. The author has treated many patients with symptomatic unruptured cerebral aneurysms and found that improved cranial nerve signs can be expected if the surgical treatment is performed before the symptoms become irreversible; the critical period is approximately 3 months. It is important to suppress the pulsation of the aneurysms compressing the cranial nerves; both a clipping procedure and endovascular coiling are effective. Cranial nerve signs are more commonly the symptoms of unruptured cerebral aneurysms, but large to giant aneurysms can also be the causes of hemiparesis, hydrocephalus, epilepsy, or even cerebral infarction. This review summarizes the features and surgical outcome of symptomatic unruptured cerebral aneurysms.

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