Reversible posterior leukoencephalopathy syndrome after lateral skull base surgery

Otol Neurotol. 2011 Jul;32(5):838-40. doi: 10.1097/MAO.0b013e31821f1b95.

Abstract

Objective: To describe the clinical course, diagnostic features and management of a case of reversible posterior leukoencephalopathy syndrome after a lateral cranial base removal.

Patient: A 58-year-old male patient with an inconspicuous clinical history presented with a lethargic state without localized neurologic deficit in the postoperative period of a subtotal petrosectomy for an adenoid cystic carcinoma of the temporal bone.

Interventions: Cranial T2-weighted magnetic resonance imaging showed increased signal intensity in the occipital and cerebellar regions, centered at the cortical and subcortical white matter. Antihypertensive drugs, anticonvulsants, and antibiotics were administered. A complete resolution of the symptoms and radiologic findings were achieved within 1 to 2 weeks.

Results: The clinical presentation, radiologic findings, and resolution of the clinical setting are consistent with a diagnosis of reversible posterior leukoencephalopathy syndrome.

Conclusion: To our knowledge, this is the first report of reversible posterior leukoencephalopathy syndrome after a lateral cranial base surgery.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Adenoid Cystic / pathology
  • Carcinoma, Adenoid Cystic / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurosurgical Procedures / adverse effects*
  • Petrous Bone / pathology
  • Petrous Bone / surgery*
  • Posterior Leukoencephalopathy Syndrome / etiology*
  • Postoperative Period
  • Skull Neoplasms / pathology
  • Skull Neoplasms / surgery*