0155 Memory impairment and frequency of visual field deficits in standard temporal lobectomy and selective amygdalohippocampectomy

2005 ◽  
Vol 238 ◽  
pp. S139
Keyword(s):  
Visual Field ◽  
Memory Impairment ◽  
Temporal Lobectomy ◽  
Selective Amygdalohippocampectomy ◽  
Visual Field Deficits

VISUAL FIELD DEFECTS IN SELECTIVE AMYGDALOHIPPOCAMPECTOMY FOR HIPPOCAMPAL SCLEROSIS

Neurosurgery ◽  
2008 ◽  
Vol 63 (3) ◽  
pp. 507-515 ◽  
Author(s):  
S. Naz Yeni ◽  
Necmettin Tanriover ◽  
Özlem Uyanik ◽  
Mustafa Onur Ulu ◽  
Çiğdem Özkara ◽  
...  
Keyword(s):  
Visual Field ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Hippocampal Sclerosis ◽  
Visual Field Defects ◽  
Selective Amygdalohippocampectomy ◽  
Temporal Horn ◽  
Visual Field Deficits ◽  
Meyer’S Loop

ABSTRACT OBJECTIVE Meyer's loop, the most vulnerable part of the optic radiations during approaches to the temporomedial region, extends to the tip of the temporal horn and is often encountered in epilepsy surgery. The risk of damaging Meyer's loop during transsylvian selective amygdalohippocampectomy peaks while accessing the temporal horn through its roof by opening the inferior limiting sulcus of the insula. In this prospective study, we sought to evaluate and identify the incidence of visual field deficits in a homogeneous group of patients who had temporal lobe epilepsy with hippocampal sclerosis and who underwent transsylvian selective amygdalohippocampectomy. METHODS We studied 30 patients who were referred for epilepsy surgery for intractable complex partial and/or secondary generalized seizures and evaluated according to a noninvasive protocol. All patients underwent selective amygdalohippocampectomy for temporal lobe epilepsy with hippocampal sclerosis using the standard transsylvian approach. Visual field deficits were examined preoperatively in 30 patients, by either a confrontation method (n = 18) or standard Goldmann perimetry (n = 12) and postoperatively in all patients using standard Humphrey digital perimetry. RESULTS Visual field examination was normal in all patients before surgery. Humphrey perimetric measurement revealed visual field deficits in 11 patients (36.6%) after surgery. CONCLUSION We have shown that there is a considerable risk of having visual field deficits after standard transsylvian selective amygdalohippocampectomy owing to the interruption of the anterior bundle of the optic radiation fibers, which most likely occurs while opening the temporal horn through the inferior limiting sulcus of the insula.

Visual field deficits following anterior temporal lobectomy: Long-term follow-up and prognostic implications

Epilepsia ◽  
2010 ◽  
Vol 51 (6) ◽  
pp. 1018-1023 ◽  
Author(s):  
Debbie Yam ◽  
David Nicolle ◽  
David A. Steven ◽  
Donald Lee ◽  
Tiiu Hess ◽  
...  
Keyword(s):  
Visual Field ◽  
Temporal Lobectomy ◽  
Anterior Temporal Lobectomy ◽  
Visual Field Deficits ◽  
Long Term Follow Up ◽  
Prognostic Implications

Selective amygdalohippocampectomy via the transsylvian approach

2008 ◽  
Vol 25 (3) ◽  
pp. E5 ◽  
Author(s):  
Badih Adada
Keyword(s):  
Visual Field ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Seizure Control ◽  
Temporal Lobectomy ◽  
Surgical Approaches ◽  
Neuropsychological Outcome ◽  
Transsylvian Approach ◽  
Selective Amygdalohippocampectomy ◽  
Established Treatment

Surgery is an established treatment for temporal lobe epilepsy refractory to medication. Several surgical approaches have been used to treat this condition including temporal lobectomy, transcortical selective amygdalohippocampectomy, subtemporal amygdalohippocampectomy, and transsylvian amygdalohippocampectomy. In this article the author reviews the transsylvian amygdalohyppocampectomy and pertinent anatomy. He also discusses the procedure's results with regard to seizure control, neuropsychological outcome, and visual field preservation.

Visual Field Defects After Selective Amygdalohippocampectomy and Standard Temporal Lobectomy

2009 ◽  
Vol 29 (3) ◽  
pp. 208-213 ◽  
Author(s):  
T Mengesha ◽  
M Abu-Ata ◽  
K F Haas ◽  
P J Lavin ◽  
D A Sun ◽  
...  
Keyword(s):  
Visual Field ◽  
Temporal Lobectomy ◽  
Visual Field Defects ◽  
Selective Amygdalohippocampectomy ◽  
Field Defects

Visual field deficits in conventional anterior temporal lobectomy versus amygdalohippocampectomy

Neurology ◽  
2000 ◽  
Vol 55 (12) ◽  
pp. 1818-1822 ◽  
Author(s):  
R. A. Egan ◽  
W. T. Shults ◽  
N. So ◽  
K. Burchiel ◽  
J. X. Kellogg ◽  
...  
Keyword(s):  
Visual Field ◽  
Temporal Lobectomy ◽  
Anterior Temporal Lobectomy ◽  
Visual Field Deficits

Visual field deficits following laser ablation of the hippocampus

Neurology ◽  
2020 ◽  
Vol 94 (12) ◽  
pp. e1303-e1313 ◽  
Author(s):  
Cristian Donos ◽  
Patrick Rollo ◽  
Kathryn Tombridge ◽  
Jessica A. Johnson ◽  
Nitin Tandon
Keyword(s):  
Visual Field ◽  
Right Hemisphere ◽  
Mesial Temporal Lobe Epilepsy ◽  
Temporal Lobectomy ◽  
Hemispheric Differences ◽  
Patient Counseling ◽  
Individual Subject ◽  
Anterior Temporal Lobectomy ◽  
Visual Field Deficits ◽  
Reported Data

ObjectiveTo qualify the incidence of and risk factors for visual field deficits (VFD) following laser interstitial thermal ablation (LITT) for mesial temporal lobe epilepsy (MTLE) and to relate this to anterior temporal lobectomy (ATL).MethodsFifty-seven patients underwent LITT of the amygdalo-hippocampal complex (AH) for MTLE. Masks of ablation volumes, laser probe trajectories, and visual radiations (VRs) from individual subject space were transformed into standardized space using nonlinear registration. Voxel-wise statistics were performed to model relationships between VFDs vs ablation volumes, laser trajectories, VRs, and AH asymmetry. A review of VFDs following ATLs was performed.ResultsThe incidence of VFD after LITT is much lower than after ATLs. A total of 37.5% of patients developed a VFD, with the probability of this being much higher after left (50%) vs right hemisphere LITT (10%) (Fisher test, p = 0.05). This laterality effect on VFDs is mirrored but underappreciated in ATL series. The most consistent LITT-VFD occurred in the superior vertical octant. Ablation of Meyer loop as well as the summed probability of VRs within laser trajectories correlated with VFDs (p < 0.05). Left and right hippocampi have significantly distinct orientations in axial and coronal planes, which may be one reason for the variation in VFD probability.ConclusionsLITT results in lower rates of and smaller VFDs—typically an octantanopsia. VRs are at greater risk during surgery for left than right MTLE. Anatomical asymmetries in hippocampal anatomy may explain the hemispheric differences in deficits, and should factor into trajectory planning and also into preoperative patient counseling. Overall the incidence and extent of visual deficits following LITT for MTLE is lower than the reported data following anterior temporal lobectomy. VF tractography incorporated into LITT planning may reduce the occurrence of VFDs.

scholarly journals Multi-scale image analysis and prediction of visual field defects after selective amygdalohippocampectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bastian David ◽  
Jasmine Eberle ◽  
Daniel Delev ◽  
Jennifer Gaubatz ◽  
Conrad C. Prillwitz ◽  
...  
Keyword(s):  
Visual Field ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Diffusion Tensor ◽  
Global Network ◽  
Visual Field Defects ◽  
Whole Brain ◽  
Network Analyses ◽  
Postoperative Mri ◽  
Selective Amygdalohippocampectomy

AbstractSelective amygdalohippocampectomy is an effective treatment for patients with therapy-refractory temporal lobe epilepsy but may cause visual field defect (VFD). Here, we aimed to describe tissue-specific pre- and postoperative imaging correlates of the VFD severity using whole-brain analyses from voxel- to network-level. Twenty-eight patients with temporal lobe epilepsy underwent pre- and postoperative MRI (T1-MPRAGE and Diffusion Tensor Imaging) as well as kinetic perimetry according to Goldmann standard. We probed for whole-brain gray matter (GM) and white matter (WM) correlates of VFD using voxel-based morphometry and tract-based spatial statistics, respectively. We furthermore reconstructed individual structural connectomes and conducted local and global network analyses. Two clusters in the bihemispheric middle temporal gyri indicated a postsurgical GM volume decrease with increasing VFD severity (FWE-corrected p < 0.05). A single WM cluster showed a fractional anisotropy decrease with increasing severity of VFD in the ipsilesional optic radiation (FWE-corrected p < 0.05). Furthermore, patients with (vs. without) VFD showed a higher number of postoperative local connectivity changes. Neither in the GM, WM, nor in network metrics we found preoperative correlates of VFD severity. Still, in an explorative analysis, an artificial neural network meta-classifier could predict the occurrence of VFD based on presurgical connectomes above chance level.

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