Skip to main content
Log in

Idiopathic chronic temporal lobe herniation with associated epilepsy

  • Case Report - Neurosurgery general
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Herniation of parahippocampal gyrus is usually caused by pressure differentials intracranially, and herniation without known risk factors is extremely rare. We describe a patient with a long history of seizures and a remote status epilepticus event. On magnetic resonance imaging, a presumed left temporal lobe tumor was observed. On neurosurgical consultation, the lesion was identified as a chronic mesial temporal lobe herniation. The patient lacked history that would suggest risk of cerebral herniation. Accurately identifying the patient’s chronic temporal lobe herniation radiographically likely saved this patient from unnecessary surgery or biopsy and allowed the patient to receive appropriate conservative care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

CSF:

Cerebrospinal fluid

MRI:

Magnetic resonance imaging

TLE:

Temporal lobe epilepsy

References

  1. Allone C, Lo Buono V, Corallo F, Pisani LR, Pollicino P, Bramanti P, Marino S (2017) Neuroimaging and cognitive functions in temporal lobe epilepsy: a review of the literature. J Neurol Sci 381:7–15

    Article  Google Scholar 

  2. Dahlqvist MB, Andres RH, Raabe A, Jakob SM, Takala J, Dunser MW (2010) Brain herniation in a patient with apparently normal intracranial pressure: a case report. J Med Case Rep 4:297

    Article  Google Scholar 

  3. Horowitz M, Kassam A, Levy E, Lunsford LD (2002) Misinterpretation of parahippocampal herniation for a posterior fossa tumor: imaging and intraoperative findings. J Neuroimaging 12:78–79

    Article  Google Scholar 

  4. Koc G, Doganay S, Bayram AK, Gorkem SB, Dogan MS, Per H, Coskun A (2014) Idiopathic brain herniation. A report of two paediatric cases. Neuroradiol J 27:586–589

    Article  Google Scholar 

  5. Komotar RJ, Mocco J, Ransom ER, Mack WJ, Zacharia BE, Wilson DA, Naidech AM, McKhann GM 2nd, Mayer SA, Fitzsimmons BF, Connolly ES Jr. (2005) Herniation secondary to critical postcraniotomy cerebrospinal fluid hypovolemia. Neurosurgery 57:286–292 (discussion 286–292)

    Article  Google Scholar 

  6. Mokri B (2001) The Monro-Kellie hypothesis: applications in CSF volume depletion. Neurology 56:1746–1748

    Article  CAS  Google Scholar 

  7. Munakomi S, J MD (2020) Brain herniation. StatPearls Treasure Island (FL)

  8. Myers KA, McMahon JM, Mandelstam SA, Mackay MT, Kalnins RM, Leventer RJ, Scheffer IE (2017) Fatal cerebral edema with status epilepticus in children with Dravet syndrome: report of 5 cases. Pediatrics 139:e20161933

  9. Stevens RD, Shoykhet M, Cadena R (2015) Emergency neurological life support: intracranial hypertension and herniation. Neurocrit Care 23:76–82

    Article  CAS  Google Scholar 

  10. Thom M, Bertram EH (2012) Temporal lobe epilepsy. Handb Clin Neurol 107:225–240

    Article  Google Scholar 

  11. Udayakumaran S, Ben Sira L, Constantini S (2010) Chronic uncal herniation secondary to posterior fossa shunting: case report and literature review. Childs Nerv Syst 26:267–271

    Article  Google Scholar 

  12. Udayakumaran S, Ben Sira L, Constantini S (2010) Temporal lobe herniation of developmental origin: a novel radiological association with open spina bifida and Chiari II malformation. Childs Nerv Syst 26:277–278

    Article  Google Scholar 

  13. Vakharia K, Kamal H, Atwal GS, Budny JL (2018) Transtentorial herniation from tumefactive multiple sclerosis mimicking primary brain tumor. Surg Neurol Int 9:208

    Article  Google Scholar 

  14. Zhang T, Ma J (2019) Focal status epilepticus-related unilateral brain edema: magnetic resonance imaging study of children in Southwest China. Pediatr Neurol 92:60–66

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank Kristin Kraus for editorial support.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to William T. Couldwell.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gamblin, A., Fredrickson, V.L., Hollon, T.C. et al. Idiopathic chronic temporal lobe herniation with associated epilepsy. Acta Neurochir 163, 2805–2808 (2021). https://doi.org/10.1007/s00701-021-04926-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-021-04926-9

Keywords

Navigation