Türk Nöroşirürji Dergisi
2020 , Vol 30 , Num 1
Microneurosurgical Anatomy of the Mesial Temporal Region
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