Kawashima Toshiyuki, Uda Takehiro, Koh Saya, Yindeedej Vich, Ishino Noboru, Ichinose Tsutomu, Arima Hironori, Sakuma Satoru, Goto Takeo
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.
Brain Sci. 2023 Mar 4;13(3):440. doi: 10.3390/brainsci13030440.
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.
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。
