Document Detail

Selective amygdalohippocampectomy for hippocampal sclerosis: postoperative MR appearance.
MedLine Citation:
PMID:  8693986     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To analyze the anatomic consequences of selective amygdalohippocampectomy (AH) in patients with hippocampal sclerosis and to correlate the clinical outcome with the MR appearance. METHODS: Seventeen patients were examined with clinical and neuropsychologic examination and cranial MR after AH (7 transcortical AH, 10 trans-Sylvian AH). The clinical and neuropsychologic outcomes after AH were compared with those of anterior lobectomy (ATL). RESULTS: There was no significant difference in seizure cure between transcortical or trans-Sylvian AH and ATL. However, patients with left AH fared significantly better in terms of verbal IQ and nonverbal memory when compared with those with left ATL. Verbal memory and cognition were not significantly different in the two AH groups. Variable amounts of hippocampal and amygdala remnants were found in both AH groups and did not correlate with seizure cure. White matter change consistent with gliosis probably secondary to wallerian degeneration was demonstrated in the anterior temporal lobe to a mean distance of 4.5 cm after transcortical AH and to a lesser degree as a consequence of trans-Sylvian AH. Nine patients (53%) (4 transcortical All, 5 trans-Sylvian AH) demonstrated wallerian degeneration in the optic radiations after surgery. All had incomplete contralateral quadrantanopia. CONCLUSIONS: There is more secondary damage to the temporal lobe after AH than was previously recognized. The extent of hippocampal and amygdala resection in AH do not seem to be directly related to seizure cure. Visual field defects are common in AH because of the anterior but variable course of the optic radiations
S A Renowden; Z Matkovic; C B Adams; K Carpenter; S Oxbury; A J Molyneux; P Anslow; J Oxbury
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  16     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1996-08-23     Completed Date:  1996-08-23     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1855-61     Citation Subset:  IM    
Department of Neuroradiology, Radcliffe Infirmary NHS Trust, Oxford, United Kingdom.
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MeSH Terms
Amygdala / surgery*
Brain / pathology*
Epilepsy, Temporal Lobe / etiology,  surgery
Hippocampus / pathology,  surgery*
Magnetic Resonance Imaging*
Postoperative Complications

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