Presentation
Seizures
Patient Data
The left hippocampus is small and of high T2 signal. Incidental pineal cyst noted.
Case Discussion
The patient went on to have an amygdalohippocampectomy.
Histology
Microscopic Description:
Sections of the mesial block confirm a mild to moderate loss of neurons within CA1 of hippocampus. Although this is sufficient to permit a diagnosis of mesial temporal sclerosis, the changes are relatively mild. There are no other major features of cortical dysplasia or cerebral dysgenesis in the mesial structures. There is no evidence of neoplasia, vascular malformation, or a previous cranial cerebral trauma. The sections of the remainder of the lateral block show focal cerebral micro-dysgenesis with a localized aggregate of neurocytic-type cells. There is no significant cortical dysplasia in the material examined. There is retraction of perivascular white matter.
Final diagnosis:
Mesial temporal sclerosis