Türk Nöroşirürji Dergisi 2020 , Vol 30 , Num 1
Microneurosurgical Anatomy of the Mesial Temporal Region
Mehmet Yiğit AKGÜN1,Süreyya TOKLU1,Cihan İŞLER1
1İstanbul Üniversitesi - Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, İstanbul, Türkiye The mesial temporal region is located at the medial part of the temporal horn at the depths of the temporal lobe. A variety of lesions such as tumors, vascular malformations and epileptic lesions can be found in the mesial temporal lobe. Lesional mesial temporal lobe epilepsy may also be associated with lesions other than the hippocampal sclerosis present in the mesial temporal lobe that cause intractable seizures. The lesions can usually be developmental malformations such as focal cortical dysplasia or developmental tumors. The mesial temporal region is adjacent to the basal cisternae and has intricate relations with important neurovascular structures. Anatomically and surgically, the mesial temporal region is divided into three regions: anterior, middle and posterior. The unique and relatively complex anatomy of the region makes surgical approaches to this region challenging. There are three main differences among the techniques. The first one is the relative extent of mesial temporal versus neocortical resection, The second one is the exact extent of mesial resection, with variations in amygdalar resection and hippocampal and parahippocampal gyrus resection. The third difference is the surgical approach (e.g., transsylvian vs. transcortical selective amygdalohippocampectomy). The ideal approach to the region depends on the patients" pathologies, goals of the surgery and preferences of the surgeons. Anahtar Kelimeler : Mesial temporal, Surgery, Anatomy, Epilepsy, Amygdalohippocampectomy, Hippocampus