Department of Neurosurgery, National Institute of Mental Health and NeuroSciences (NIMHANS), Bangalore, India.
Department of Neurology, National Institute of Mental Health and NeuroSciences (NIMHANS), Bangalore, India.
Acta Neurochir Suppl. 2023;130:109-119. doi: 10.1007/978-3-030-12887-6_14.
Anterior temporal lobectomy with amygdalohippocampectomy is the most common epilepsy surgery, which, in cases of mesial temporal lobe epilepsy caused by mesial temporal sclerosis, usually leads to improvements in seizure control, cognitive function, and quality of life. Nevertheless, while the primary goal of intervention is achieved in a large majority of patients, a small number of them, unfortunately, encounter complications. Some morbidity is nonspecific and may be noted after any craniotomy (e.g., surgical site infections, meningitis, bone flap osteomyelitis, and operative site or craniotomy-related hematomas). On the other hand, certain complications are specifically associated with surgery for temporal lobe epilepsy and can be discussed from the etiological standpoint: mechanical injuries of the brain; injury of eloquent neuronal structures; arterial and venous injuries; cerebral venous thrombosis; remote cerebellar hemorrhage; and postoperative hydrocephalus, seizures, and psychiatric disorders. In many cases, these complications are manifested in the early postoperative period by alterations of consciousness and a focal neurological deficit, and it may require immediate decisions on their appropriate management.
前颞叶切除术联合杏仁核海马切除术是最常见的癫痫手术，对于由内侧颞叶硬化引起的内侧颞叶癫痫，通常可改善癫痫发作的控制、认知功能和生活质量。然而，尽管干预的主要目标在大多数患者中得以实现，但不幸的是，仍有少数患者出现并发症。一些发病率是非特异性的，可能在任何开颅手术后都能观察到（例如，手术部位感染、脑膜炎、骨瓣骨髓炎、手术部位或开颅术相关血肿）。另一方面，某些并发症与颞叶癫痫手术有明确关联，可以从病因学角度进行讨论：脑的机械性损伤；语言相关神经元结构损伤；动静脉损伤；脑静脉血栓形成；小脑远隔部位出血；以及术后脑积水、癫痫发作和精神障碍。在许多情况下，这些并发症在术后早期表现为意识改变和局灶性神经功能缺损，可能需要立即对其进行适当的处理。
