Hippocampal sclerosis

Case contributed by RMH Neuropathology



Patient Data

Age: 44
Gender: Female

Despite the motion artefact during the acquisition of the coronal hippocampal sequences, there is clear asymmetry to the hippocampi. The left hippocampus is smaller than the right and there is discrete blurring of the grey-white matter interface along the parahippocampal sulcus. 


Features consistent with left mesial temporal sclerosis.


Fig 1A: normal hippocampus from another patient for comparison. 


Fig 1B: Serial sections of hippocampus show almost complete loss of neurons from the CA1 sector of the hippocampal cortex as well as from CA3 and CA4. There is relative preservation of neuronal numbers in CA2. There is also depletion of neurons from the dentate fasciculus with dispersion of residual neurons. The neuronal depletion is accompanied by moderate astrocytic gliosis. The features are of hippocampal sclerosis - Blumke Type 1a.

(not shown) The sections of temporal neocortex show preservation of laminar architecture. No features of malformation of cortical development are seen. Scattered neurons are noted in white matter. Myelination appears normal and there is no evidence of tumor.

(not shown) The sections of amygdala show no specific diagnostic abnormality. No features of amygdala dysplasia or sclerosis are seen. There is no evidence of tumor.


Hippocampal sclerosis Blumke Type 1b. 

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