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.
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Abbreviations
- CSF:
-
Cerebrospinal fluid
- MRI:
-
Magnetic resonance imaging
- TLE:
-
Temporal lobe epilepsy
References
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
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
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
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
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)
Mokri B (2001) The Monro-Kellie hypothesis: applications in CSF volume depletion. Neurology 56:1746–1748
Munakomi S, J MD (2020) Brain herniation. StatPearls Treasure Island (FL)
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
Stevens RD, Shoykhet M, Cadena R (2015) Emergency neurological life support: intracranial hypertension and herniation. Neurocrit Care 23:76–82
Thom M, Bertram EH (2012) Temporal lobe epilepsy. Handb Clin Neurol 107:225–240
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
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
Vakharia K, Kamal H, Atwal GS, Budny JL (2018) Transtentorial herniation from tumefactive multiple sclerosis mimicking primary brain tumor. Surg Neurol Int 9:208
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
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We would like to thank Kristin Kraus for editorial support.
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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
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DOI: https://doi.org/10.1007/s00701-021-04926-9