White Fiber Correlates of Amygdalohippocampectomy Through the Middle Temporal Gyrus Approach

Clinical and anatomical analysis of the epileptogenic spread patterns in focal cortical dysplasia patients

“…[ 44 ] This is because primary FCD lesions have closely linked EZ inter-connectives, through which seizures may spread. [ 28 , 41 ] The EZ is seen as complex structure composed of primary foci, relay, and subrelay areas essential to produce individual ictal symptoms and signs resulting in characteristic seizure patterns. [ 30 ] In some instances, multiple epileptogenic foci may exist independently [ Tables 2 and 3 ].…”

Lesional mesial temporal lobe epilepsy in children: is there a superior surgical approach?

“…Uda et al [23] concluded that visual field deficits (83% vs. 60% respectively) and memory function were comparable between the trans-MTG approach and the transsylvian approach, with a shorter time of surgery for the trans-MTG approach. The typical trans-MTG approach, apart from damaging the lateral temporal neocortex, puts at risk some crucial white matter tracts (WMTs), such as inferior frontooccipital fasciculus (IFOF) and Meyer's loop [24,25].…”

“…On the other hand, it has been suggested that the transsylvian approach may be more selective, allowing for less interruption of WMTs (especially optic radiation fibres) and preservation of the lateral temporal neocortex [25]. It is worth remembering that it has been found that the transsylvian Neurologia i Neurochirurgia Polska 2024 www.journals.viamedica.pl/neurologia_neurochirurgia_polska approach also interrupts IFOF, uncinate fasciculus (UF), and optic radiation fibres [24]. Moreover, some papers have indicated the presence of gliosis and neuronal loss in the temporal pole following the transsylvian approach [26,27].…”

“…Moreover, some papers have indicated the presence of gliosis and neuronal loss in the temporal pole following the transsylvian approach [26,27]. Recently, Shah et al [24] proposed a modified technique for trans-MTG selective amygdalohippocampectomy that included a safe-entry zone in the anterior part of the lateral wall of the temporal horn. They suggested that a surgical approach focused on entering the temporal horn first, and then performing an en bloc resection of the amygdala, hippocampus, uncus, parahippocampus, and lateral neocortex, respectively, may preserve IFOF and Meyer's loop fibres, making the trans-MTG approach safer.…”

The Inferior Temporal Gyrus Approach to Mesial Basal Temporal Lobe Surgery: 2-Dimensional Operative Video

“…The inferior temporal gyrus approach avoids symptomatic optic radiation fibers and eloquent cortex while requiring little cortical retraction and demonstrating exceptional outcomes. [1][2][3][4][5][6][7][8][9][10][11][12][13] We present this approach in a 39-yearold patient who presented with right upper extremity numbness and pain along with a return of her seizures after a gross total resection of an astrocytoma involving the right hippocampus 8 years prior. On admission, she was neurologically intact, and MRI demonstrated localized signal intensity in the right hippocampus suggesting a tumor recurrence.…”