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Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury
Published on: November 19, 2012
[Clinical characteristics and operative effect of hippocampus lesions]
Xingjun Jiang1, Zhiquan Yang, Xianrui Yuan
1Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Insights
Hippocampus lesions commonly cause seizure attacks. Surgical treatments like anterior medial temporal lobectomy or lesionectomy offer effective seizure and tumor control for patients with these brain lesions.
Area of Science:
- Neurosurgery
- Neurology
- Pathology
Context:
- Hippocampus lesions are a significant cause of neurological dysfunction, particularly epilepsy.
- Understanding the clinical spectrum and surgical outcomes is crucial for patient management.
Purpose:
- To investigate the clinical features and surgical outcomes of patients with hippocampus lesions.
- To evaluate the effectiveness of different surgical approaches for treating these lesions.
Summary:
- Retrospective analysis of 44 patients with hippocampus lesions revealed seizures as the primary symptom in 40.
- Pathologies included gliomas, cavernous malformations, and hippocampus sclerosis.
- Surgical interventions, such as anterior medial temporal lobectomy and lesionectomy, resulted in good seizure control (Engel Grade I in 73%) with acceptable morbidity.
Impact:
- Surgical interventions provide satisfactory seizure and tumor control for hippocampus lesions.
- This study informs surgical decision-making and highlights the importance of tailored treatment strategies.
Objective:
To study the clinical characteristics and operative effect of hippocampus lesions.
Methods:
We retrospectively analyzed the clinical characteristics and operative outcome of 44 patients with hippocampus lesions between August 2005 and April 2010.
Results:
Seizure attack was the initial symptom among 40 of the 44 patients. Pathological examinations revealed 18 gliomas, 9 cavernous malformations, 12 hippocampus sclerosis, 2 focal cortical dysplasia, 1 atypical hyperplasia, 1 injury glial scar, and 1 encephalomalacia. Thirteen patients received anterior medial temporal lobectomy and the other 31 received lesionectomy or selective amygdalohippocampectomy via transsylvian approach. An average of 15.7 month follow-up was accomplished in 37 patients. Postoperative epileptic outcomes were evaluated according to Engel classification: Grade I 73.0%(27/37), Grade II 13.5%(5/37), Grade III 10.8%(4/37) and Grade IV 2.7%(1/37). No perioperative death occurred. One patient experienced hemiplegia but recovered 8 months after the operation. Noticeable postoperative visual field deficit was left in 2 patients. Two patients with glioma died of remote tumor recurrence during follow-up.
Conclusion:
Seizure attack is a major complaint of hippocampus lesions. Satisfactory seizure and tumor control may be achieved through anterior medial temporal lobectomy or selective amygdalohippocampectomy with lesionectomy.
