Neurosurgery for cavernous malformation in left temporoparietal region

Name: Mr. Wu
Gender: Male
Country: China
Age: 45
Diagnosis: Cavernous malformation in left temporoparietal region
Treatment method: Left temporoparietal craniotomy with lesion resection, under a general anesthesia

Background

Mr. Wu, a 45 year old male patient from China, was admitted into Beijing Tiantan Puhua International Hospital, due to physical activity dysfunction of the right extremities for six months, and one epileptic seizure per month.

Medical condition pre surgery

Mr. Wu experienced a progressive physical activity dysfunction of the right extremities from about six months ago. He suffered an Epilepsia Gravior (Grand Mal seizure) per month, accompanied with frothy sputum from his mouth, followed by short period of unconsciousness. He had no urinary and fecal incontinence.

The Epilepsia Gravior (Grand Mal seizure) lasted for 4 - 6 minutes, and then dissipated. He did not receive any systemic treatment prior to coming to Beijing Tiantan Puhua International Hospital.

Upon arrival, the patient was alert. The muscle tone of all of his limbs was normal. Myodynamia of his right upper and lower extremities were “IV”, lower than the normal level of “V”, which meant he had less strength in his right upper and lower extremities. He had tendon hyper-reflexia. Pathological reflexes were positive on the right side.

A cerebral MRI revealed that there was a clumping like occupying lesion in the left temporoparietal region, with a clear margin. No obvious edema was apparent. Cavernous malformation was possible.

Surgical approach

Left temporoparietal craniotomy with lesion resection, under a general anesthesia. The procedure took approximately three hours and the lump was completely removed.

Medical condition post surgery

After the procedure, he recovered well. There was no occurrence of severe postoperative complications, such as: hemorrhage, and/or severe brain edema, etc. He was prescribed with the anti-epileptic/anticonvulsant drug: Sodium Valproate Tm.
Post surgery, he had no repeat occurrence of the epileptic seizures he had experienced before coming to the hospital. His sutures were removed ten days post surgery. He was discharged following a successful healing of his incision.

Follow up

Eight months later, a repeat cerebral MRI revealed no relapse or any residue of the tumor. He now has normal movements of all of his extremities. Myodynamia of all limbs are at Grade “V”, the normal level. He no longer suffers any Epilepsia Gravior since his surgery.