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Aaron A Cohengadol - One of the best experts on this subject based on the ideXlab platform.

  • superficial cortical landmarks for localization of the hippocampus application for Temporal lobectomy and amygdalohippocampectomy
    Surgical Neurology International, 2015
    Co-Authors: Shane R Tubbs, Nicholas M. Barbaro, Marios Loukas, Aaron A Cohengadol
    Abstract:

    Background: Accessing the hippocampus for amygdalohippocampectomy and minimally invasive procedures, such as depth electrode placement, require an accurate knowledge regarding the location of the hippocampus. Methods: The authors removed 10 human cadaveric brains from the cranium and observed the relationships between the lateral Temporal neocortex and the underlying hippocampus. They then measured the distance between the hippocampus and superficial landmarks. The authors also validated their study using magnetic resonance imaging (MRI) scans of 10 patients suffering from medial Temporal lobe sclerosis where the distance from the hippocampal head to the anterior Temporal tip was measured. Results: In general, the length of the hippocampus was along the Inferior Temporal Sulcus and Inferior aspect of the middle Temporal gyrus. Although the hippocampus tended to be more superiorly located in female specimens and on the left side, this did not reach statistical significance. The length of the hippocampus tended to be shorter in females, but this too failed to reach statistical significance. The mean distance from the anterior Temporal tip to the hippocampal head was identical in the cadavers and MRIs of patients with medial Temporal lobe sclerosis. Conclusions: Additional landmarks for localizing the underlying hippocampus may be helpful in Temporal lobe surgery. Based on this study, there are relatively constant anatomical landmarks between the hippocampus and overlying Temporal cortex. Such landmarks may be used in localizing the hippocampus during amygdalohippocampectomy and depth electrode implantation in verifying the accuracy of image-guided methods and as adjuvant methodologies when these latter technologies are not used or are unavailable.

  • external cortical landmarks and measurements for the Temporal horn anatomic study with application to surgery of the Temporal lobe
    Surgical Neurology International, 2015
    Co-Authors: Shane R Tubbs, Marios Loukas, Amit Sharma, Aaron A Cohengadol
    Abstract:

    Background The location of the Temporal horn is important to neurosurgeons during procedures such as amygdalohippocampectomy and intraventricular electrode placement for Temporal lobe seizure monitoring. However, sometimes the Temporal horn is difficult to localize, especially without neuronavigation. The authors aimed to better localize this structure using superficial anatomic landmarks. Methods Twenty-two brain halves were dissected from the midline, and the fornix identified and followed toward the left and right Temporal horns. Once the Temporal horn was isolated from a mesial approach, 6-cm long needles were placed into its anterior and posterior walls of the Temporal horn and passed laterally from the axial plane to the cortical surface. Pin exit sites were marked externally and measurements taken between the outer Temporal lobe cortex and the underlying Temporal horn. Results No statistical differences were noted between left and right sides. The Temporal horn was generally directed anteroInferiorly and best marked externally by the Inferior Temporal Sulcus. The mean length of the Temporal horn was 4.4 cm. Mean distance from anterior Temporal tip to anterior wall of the Temporal horn was 3.3 cm. The mean distance from the anterior Temporal tip to the posterior wall of the Temporal horn was 7 cm. The anterior wall of the Temporal horn was a mean of 3 mm superior to the Inferior Temporal Sulcus. The posterior wall was a mean of 1.2 cm superior to the Inferior Temporal Sulcus. Conclusions These landmarks and measurements may help neurosurgeons better localize this part of the lateral ventricular system.

Kazufumi Kamikaseda - One of the best experts on this subject based on the ideXlab platform.

  • Inferior Temporal Sulcus approach for amygdalohippocampectomy guided by a laser beam of stereotactic navigator
    Neurosurgery, 2003
    Co-Authors: Yasushi Miyagi, Fumio Shima, Katsuya Ishido, Takehisa Araki, Yoshihide Taniwaki, Iku Okamoto, Kazufumi Kamikaseda
    Abstract:

    Objective To describe a surgical technique for a minimally invasive transcortical transventricular amygdalohippocampectomy via the Inferior Temporal Sulcus (ITS) using a stereotactic navigator. Methods Seven patients with medically intractable mesial Temporal lobe epilepsy underwent an amygdalohippocampectomy via the ITS. By use of a laser-guided navigation system, the epileptogenic foci of the mesial Temporal lobe were resected through a small linear operative route that was made by a brain speculum inserted from the ITS to the anterolateral floor of the Temporal horn in the lateral ventricle. Results All patients completed at least a 1-year follow-up (range, 14-45 mo) after surgery and had improved neuropsychological parameters as a result of the operation. All patients became seizure-free after surgery. A Humphrey visual field perimeter detected no hemianopsia. Conclusion Combined with the stereotactic navigation system, the ITS approach provides the least invasive amygdalohippocampectomy that preserves optic radiation. This approach seems beneficial especially in patients in whom the epileptic lesions are limited to the anterior mesial Temporal lobe.

  • Inferior Temporal Sulcus as a site of corticotomy magnetic resonance imaging analysis of individual Sulcus patterns
    Neurosurgery, 2001
    Co-Authors: Yasushi Miyagi, Fumio Shima, Katsuya Ishido, Takehisa Araki, Kazufumi Kamikaseda
    Abstract:

    OBJECTIVE: Transcortical approaches to the Inferior horn often result in quadrant hemianopsia attributable to the injury to the optic radiation. The Inferior Temporal Sulcus (ITS) has received little attention as an entrance point for the transsulcal approach. We used the method of detecting the ITS with magnetic resonance imaging (MRI) scans and investigated the Sulcus pattern of ITS, its incidence rate, and the availability of the ITS to the corticotomy for selective amygdalohippocampectomy. METHODS: The Sulcus patterns of the ITS of 100 Temporal lobes in 50 healthy individuals were classified according to the number of interruptions by gyral bridges, and the localization of the ITS was characterized in relation to the outer surface by means of the surface anatomy scan of MRI. RESULTS: Most of the ITS was interrupted by one to three gyral bridges (0 bridges, 8%; one bridge, 27%: two bridges, 37%; three bridges, 20%; more than four bridges or no apparent ITS, 8%). When the ITS was present, it was located 15 mm above the orbitotragus line at a point 20 mm anterior to the tragus. The number of gyral bridges was significantly larger in the left Temporal lobes than in the right Temporal lobes, regardless of the sex of the subject. CONCLUSION: The ITS was clearly identified in 72% of the Temporal lobes by the oblique sagittal view of MRI scans; thus, in such cases, the ITS was considered to be a candidate for an entrance point of a small Temporal corticotomy. The preoperative observation of the ITS in relation to the orbitotragus line by means of MRI may improve the planning of the transsulcal approaches to deeply seated mesial Temporal lesions, such as hippocampal sclerosis.(Neurosurgery 49:1394‐1398, 2001)

Shane R Tubbs - One of the best experts on this subject based on the ideXlab platform.

  • superficial cortical landmarks for localization of the hippocampus application for Temporal lobectomy and amygdalohippocampectomy
    Surgical Neurology International, 2015
    Co-Authors: Shane R Tubbs, Nicholas M. Barbaro, Marios Loukas, Aaron A Cohengadol
    Abstract:

    Background: Accessing the hippocampus for amygdalohippocampectomy and minimally invasive procedures, such as depth electrode placement, require an accurate knowledge regarding the location of the hippocampus. Methods: The authors removed 10 human cadaveric brains from the cranium and observed the relationships between the lateral Temporal neocortex and the underlying hippocampus. They then measured the distance between the hippocampus and superficial landmarks. The authors also validated their study using magnetic resonance imaging (MRI) scans of 10 patients suffering from medial Temporal lobe sclerosis where the distance from the hippocampal head to the anterior Temporal tip was measured. Results: In general, the length of the hippocampus was along the Inferior Temporal Sulcus and Inferior aspect of the middle Temporal gyrus. Although the hippocampus tended to be more superiorly located in female specimens and on the left side, this did not reach statistical significance. The length of the hippocampus tended to be shorter in females, but this too failed to reach statistical significance. The mean distance from the anterior Temporal tip to the hippocampal head was identical in the cadavers and MRIs of patients with medial Temporal lobe sclerosis. Conclusions: Additional landmarks for localizing the underlying hippocampus may be helpful in Temporal lobe surgery. Based on this study, there are relatively constant anatomical landmarks between the hippocampus and overlying Temporal cortex. Such landmarks may be used in localizing the hippocampus during amygdalohippocampectomy and depth electrode implantation in verifying the accuracy of image-guided methods and as adjuvant methodologies when these latter technologies are not used or are unavailable.

  • external cortical landmarks and measurements for the Temporal horn anatomic study with application to surgery of the Temporal lobe
    Surgical Neurology International, 2015
    Co-Authors: Shane R Tubbs, Marios Loukas, Amit Sharma, Aaron A Cohengadol
    Abstract:

    Background The location of the Temporal horn is important to neurosurgeons during procedures such as amygdalohippocampectomy and intraventricular electrode placement for Temporal lobe seizure monitoring. However, sometimes the Temporal horn is difficult to localize, especially without neuronavigation. The authors aimed to better localize this structure using superficial anatomic landmarks. Methods Twenty-two brain halves were dissected from the midline, and the fornix identified and followed toward the left and right Temporal horns. Once the Temporal horn was isolated from a mesial approach, 6-cm long needles were placed into its anterior and posterior walls of the Temporal horn and passed laterally from the axial plane to the cortical surface. Pin exit sites were marked externally and measurements taken between the outer Temporal lobe cortex and the underlying Temporal horn. Results No statistical differences were noted between left and right sides. The Temporal horn was generally directed anteroInferiorly and best marked externally by the Inferior Temporal Sulcus. The mean length of the Temporal horn was 4.4 cm. Mean distance from anterior Temporal tip to anterior wall of the Temporal horn was 3.3 cm. The mean distance from the anterior Temporal tip to the posterior wall of the Temporal horn was 7 cm. The anterior wall of the Temporal horn was a mean of 3 mm superior to the Inferior Temporal Sulcus. The posterior wall was a mean of 1.2 cm superior to the Inferior Temporal Sulcus. Conclusions These landmarks and measurements may help neurosurgeons better localize this part of the lateral ventricular system.

Yasushi Miyagi - One of the best experts on this subject based on the ideXlab platform.

  • Inferior Temporal Sulcus approach for amygdalohippocampectomy guided by a laser beam of stereotactic navigator
    Neurosurgery, 2003
    Co-Authors: Yasushi Miyagi, Fumio Shima, Katsuya Ishido, Takehisa Araki, Yoshihide Taniwaki, Iku Okamoto, Kazufumi Kamikaseda
    Abstract:

    Objective To describe a surgical technique for a minimally invasive transcortical transventricular amygdalohippocampectomy via the Inferior Temporal Sulcus (ITS) using a stereotactic navigator. Methods Seven patients with medically intractable mesial Temporal lobe epilepsy underwent an amygdalohippocampectomy via the ITS. By use of a laser-guided navigation system, the epileptogenic foci of the mesial Temporal lobe were resected through a small linear operative route that was made by a brain speculum inserted from the ITS to the anterolateral floor of the Temporal horn in the lateral ventricle. Results All patients completed at least a 1-year follow-up (range, 14-45 mo) after surgery and had improved neuropsychological parameters as a result of the operation. All patients became seizure-free after surgery. A Humphrey visual field perimeter detected no hemianopsia. Conclusion Combined with the stereotactic navigation system, the ITS approach provides the least invasive amygdalohippocampectomy that preserves optic radiation. This approach seems beneficial especially in patients in whom the epileptic lesions are limited to the anterior mesial Temporal lobe.

  • Inferior Temporal Sulcus as a site of corticotomy magnetic resonance imaging analysis of individual Sulcus patterns
    Neurosurgery, 2001
    Co-Authors: Yasushi Miyagi, Fumio Shima, Katsuya Ishido, Takehisa Araki, Kazufumi Kamikaseda
    Abstract:

    OBJECTIVE: Transcortical approaches to the Inferior horn often result in quadrant hemianopsia attributable to the injury to the optic radiation. The Inferior Temporal Sulcus (ITS) has received little attention as an entrance point for the transsulcal approach. We used the method of detecting the ITS with magnetic resonance imaging (MRI) scans and investigated the Sulcus pattern of ITS, its incidence rate, and the availability of the ITS to the corticotomy for selective amygdalohippocampectomy. METHODS: The Sulcus patterns of the ITS of 100 Temporal lobes in 50 healthy individuals were classified according to the number of interruptions by gyral bridges, and the localization of the ITS was characterized in relation to the outer surface by means of the surface anatomy scan of MRI. RESULTS: Most of the ITS was interrupted by one to three gyral bridges (0 bridges, 8%; one bridge, 27%: two bridges, 37%; three bridges, 20%; more than four bridges or no apparent ITS, 8%). When the ITS was present, it was located 15 mm above the orbitotragus line at a point 20 mm anterior to the tragus. The number of gyral bridges was significantly larger in the left Temporal lobes than in the right Temporal lobes, regardless of the sex of the subject. CONCLUSION: The ITS was clearly identified in 72% of the Temporal lobes by the oblique sagittal view of MRI scans; thus, in such cases, the ITS was considered to be a candidate for an entrance point of a small Temporal corticotomy. The preoperative observation of the ITS in relation to the orbitotragus line by means of MRI may improve the planning of the transsulcal approaches to deeply seated mesial Temporal lesions, such as hippocampal sclerosis.(Neurosurgery 49:1394‐1398, 2001)

Marios Loukas - One of the best experts on this subject based on the ideXlab platform.

  • superficial cortical landmarks for localization of the hippocampus application for Temporal lobectomy and amygdalohippocampectomy
    Surgical Neurology International, 2015
    Co-Authors: Shane R Tubbs, Nicholas M. Barbaro, Marios Loukas, Aaron A Cohengadol
    Abstract:

    Background: Accessing the hippocampus for amygdalohippocampectomy and minimally invasive procedures, such as depth electrode placement, require an accurate knowledge regarding the location of the hippocampus. Methods: The authors removed 10 human cadaveric brains from the cranium and observed the relationships between the lateral Temporal neocortex and the underlying hippocampus. They then measured the distance between the hippocampus and superficial landmarks. The authors also validated their study using magnetic resonance imaging (MRI) scans of 10 patients suffering from medial Temporal lobe sclerosis where the distance from the hippocampal head to the anterior Temporal tip was measured. Results: In general, the length of the hippocampus was along the Inferior Temporal Sulcus and Inferior aspect of the middle Temporal gyrus. Although the hippocampus tended to be more superiorly located in female specimens and on the left side, this did not reach statistical significance. The length of the hippocampus tended to be shorter in females, but this too failed to reach statistical significance. The mean distance from the anterior Temporal tip to the hippocampal head was identical in the cadavers and MRIs of patients with medial Temporal lobe sclerosis. Conclusions: Additional landmarks for localizing the underlying hippocampus may be helpful in Temporal lobe surgery. Based on this study, there are relatively constant anatomical landmarks between the hippocampus and overlying Temporal cortex. Such landmarks may be used in localizing the hippocampus during amygdalohippocampectomy and depth electrode implantation in verifying the accuracy of image-guided methods and as adjuvant methodologies when these latter technologies are not used or are unavailable.

  • external cortical landmarks and measurements for the Temporal horn anatomic study with application to surgery of the Temporal lobe
    Surgical Neurology International, 2015
    Co-Authors: Shane R Tubbs, Marios Loukas, Amit Sharma, Aaron A Cohengadol
    Abstract:

    Background The location of the Temporal horn is important to neurosurgeons during procedures such as amygdalohippocampectomy and intraventricular electrode placement for Temporal lobe seizure monitoring. However, sometimes the Temporal horn is difficult to localize, especially without neuronavigation. The authors aimed to better localize this structure using superficial anatomic landmarks. Methods Twenty-two brain halves were dissected from the midline, and the fornix identified and followed toward the left and right Temporal horns. Once the Temporal horn was isolated from a mesial approach, 6-cm long needles were placed into its anterior and posterior walls of the Temporal horn and passed laterally from the axial plane to the cortical surface. Pin exit sites were marked externally and measurements taken between the outer Temporal lobe cortex and the underlying Temporal horn. Results No statistical differences were noted between left and right sides. The Temporal horn was generally directed anteroInferiorly and best marked externally by the Inferior Temporal Sulcus. The mean length of the Temporal horn was 4.4 cm. Mean distance from anterior Temporal tip to anterior wall of the Temporal horn was 3.3 cm. The mean distance from the anterior Temporal tip to the posterior wall of the Temporal horn was 7 cm. The anterior wall of the Temporal horn was a mean of 3 mm superior to the Inferior Temporal Sulcus. The posterior wall was a mean of 1.2 cm superior to the Inferior Temporal Sulcus. Conclusions These landmarks and measurements may help neurosurgeons better localize this part of the lateral ventricular system.