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立体定向脑电图术中因间接相邻动脉损伤导致的脑实质内和蛛网膜下腔出血：病例报告

Intraparenchymal and Subarachnoid Hemorrhage in Stereotactic Electroencephalography Caused by Indirect Adjacent Arterial Injury: Illustrative Case.

作者信息

Kawashima Toshiyuki, Uda Takehiro, Koh Saya, Yindeedej Vich, Ishino Noboru, Ichinose Tsutomu, Arima Hironori, Sakuma Satoru, Goto Takeo

机构信息

Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan.

Division of Neurosurgery, Department of Surgery, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand.

出版信息

Brain Sci. 2023 Mar 4;13(3):440. doi: 10.3390/brainsci13030440.

DOI:10.3390/brainsci13030440
PMID:36979250
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10046659/
Abstract

The complication rate of stereotactic electroencephalography (SEEG) is generally low, but various types of postoperative hemorrhage have been reported. We presented an unusual hemorrhagic complication after SEEG placement. A 20-year-old man presented with suspected frontal lobe epilepsy. We implanted 11 SEEG electrodes in the bilateral frontal lobes and the left insula. Computed tomography after implantation showed intraparenchymal hemorrhage in the left temporal lobe and insula and subarachnoid hemorrhage in the left Sylvian cistern. Later, the point of vessel injury was revealed from the identification of a pseudoaneurysm, but this location was not along the planned or actual electrode trajectory. The cause of hemorrhage was suggested to be indirect injury from stretching of the arachnoid trabeculae by the puncture needle.

摘要

立体定向脑电图（SEEG）的并发症发生率通常较低，但已有各种类型的术后出血的报道。我们报告了一例SEEG植入术后罕见的出血性并发症。一名20岁男性因疑似额叶癫痫就诊。我们在双侧额叶和左侧脑岛植入了11根SEEG电极。植入后计算机断层扫描显示左侧颞叶和脑岛实质内出血以及左侧大脑外侧裂池蛛网膜下腔出血。后来，通过识别一个假性动脉瘤发现了血管损伤点，但该位置并不在计划或实际的电极轨迹上。出血原因被认为是穿刺针拉伸蛛网膜小梁导致的间接损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/8fdbd2e14d47/brainsci-13-00440-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/d47b6eac0e57/brainsci-13-00440-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/a275b4aba310/brainsci-13-00440-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/3a7053ff7121/brainsci-13-00440-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/faaaac88f317/brainsci-13-00440-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/9a07aa8bc0bc/brainsci-13-00440-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/8fdbd2e14d47/brainsci-13-00440-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/d47b6eac0e57/brainsci-13-00440-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/a275b4aba310/brainsci-13-00440-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/3a7053ff7121/brainsci-13-00440-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/faaaac88f317/brainsci-13-00440-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/9a07aa8bc0bc/brainsci-13-00440-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f4/10046659/8fdbd2e14d47/brainsci-13-00440-g006.jpg

相似文献

[1]
Intraparenchymal and Subarachnoid Hemorrhage in Stereotactic Electroencephalography Caused by Indirect Adjacent Arterial Injury: Illustrative Case.

Brain Sci. 2023-3-4

[2]
Delayed intracranial hematoma following stereoelectroencephalography for intractable epilepsy: case report.

J Neurosurg Pediatr. 2012-12

[3]
Indications, technique, and safety profile of insular stereoelectroencephalography electrode implantation in medically intractable epilepsy.

J Neurosurg. 2017-6-16

[4]
Frameless robot-assisted stereoelectroencephalography in children: technical aspects and comparison with Talairach frame technique.

J Neurosurg Pediatr. 2018-7

[5]
The Usefulness of Intraoperative Cerebral C-Arm CT Angiogram for Implantation of Intracranial Depth Electrodes in Stereotactic Electroencephalography Procedure.

Stereotact Funct Neurosurg. 2016

[6]
[Efficacy and safety of conformal thermocoagulation guided by stereotactic electroencephalogram in the treatment of epilepsy caused by focal cortical dysplasia in eloquent cortex].

Zhonghua Yi Xue Za Zhi. 2021-11-9

[7]
How can the accuracy of SEEG be increased?-an analysis of the accuracy of multilobe-spanning SEEG electrodes based on a frameless stereotactic robot-assisted system.

Ann Palliat Med. 2021-4

[8]
Stereotactic depth electrode investigation of the insula in the evaluation of medically intractable epilepsy.

J Neurosurg. 2010-10-15

[9]
Digital Subtraction Angiography May Reduce the Rate of Radiographic Hemorrhage in Stereoelectroencephalography.

World Neurosurg. 2022-8

[10]
Medically resistant pediatric insular-opercular/perisylvian epilepsy. Part 1: invasive monitoring using the parasagittal transinsular apex depth electrode.

J Neurosurg Pediatr. 2016-11

引用本文的文献

[1]
Clinical Applicability and Safety of Conventional Frame-Based Stereotactic Techniques for Stereoelectroencephalography.

J Korean Neurosurg Soc. 2024-11

[2]
De novo cerebral pseudoaneurysm formation: a rare delayed complication of stereotactic electroencephalography in children.

Childs Nerv Syst. 2024-5

[3]
Neuroimaging of Brain Tumor Surgery and Epilepsy.

Brain Sci. 2023-12-10

本文引用的文献

[1]
Primary Experiences with Robot-assisted Navigation-based Frameless Stereo-electroencephalography: Higher Accuracy than Neuronavigation-guided Manual Adjustment.

Neurol Med Chir (Tokyo). 2022-8-15

[2]
Variation in pediatric stereoelectroencephalography practice among pediatric neurosurgeons in the United States: survey results.

J Neurosurg Pediatr. 2021-6-18

[3]
Frame-based and robot-assisted insular stereo-electroencephalography via an anterior or posterior oblique approach.

J Neurosurg. 2021-4-30

[4]
Technical Aspects of SEEG and Its Interpretation in the Delineation of the Epileptogenic Zone.

Neurol Med Chir (Tokyo). 2020-12-15

[5]
Risk analysis of hemorrhage in stereo-electroencephalography procedures.

Epilepsia. 2019-2-12

[6]
French guidelines on stereoelectroencephalography (SEEG).

Neurophysiol Clin. 2017-12-23

[7]
Indications, technique, and safety profile of insular stereoelectroencephalography electrode implantation in medically intractable epilepsy.

J Neurosurg. 2017-6-16

[8]
Implantation of Stereoelectroencephalography Electrodes: A Systematic Review.

J Clin Neurophysiol. 2016-12

[9]
The history of invasive EEG evaluation in epilepsy patients.

Seizure. 2016-10

[10]
Is SEEG safe? A systematic review and meta-analysis of stereo-electroencephalography-related complications.

Epilepsia. 2016-3

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