Mesial temporal sclerosis

Case contributed by Dr Andrew Lawson

Presentation

Refractory epilepsy.

Patient Data

Age: 30
Gender: Male
MRI

The right hippocampus is smaller than the left and shows higher T2 signal, consistent with hippocampal sclerosis

MRI

A right temporal craniotomy has been performed. A large CSF filled surgical cavity is visible within the right middle cranial fossa, with resection of the amygdala, hippocampal head, body and proximal tail (back to almost the level of the tectal plate). There is minimal high T2 signal at the posterior resection margin, presumably representing a small amount of gliosis, with the remaining hippocampal tail appearing small and of high T2 signal. No significant hemosiderin staining.

Case Discussion

The patient has subsequently undergone right temporal lobectomy.

Note the relevant post-operative findings: estimation of extent of excision, presence of blood blood product and morphological appearance of remainder of lobe.

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Case information

rID: 25703
Case created: 4th Nov 2013
Last edited: 29th Sep 2015
Inclusion in quiz mode: Included

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