OBJECTIVE: To evaluate and identify the incidence of visual field defects (VFD) after anterior temporal lobectomy (ATL) versus amygdalohippocampectomy (AH). VFD occur frequently after ATL and are usually superotemporal quadrantanopias. Little is known about the incidence of VFD after AH and this surgical method offers the possibility of a seizure-free survival without visual loss. METHODS: Patients with similar characteristics were examined. All patients had intractable seizures and mesial temporal sclerosis, small tumors localized to only the uncus, amygdala, or hippocampus, or no known pathology. Postoperative kinetic field testing using the I4e isopter on a Goldmann perimeter was performed 30 days or more after surgery. RESULTS: Of 29 patients examined, 14 underwent AH and 15 had ATL. Four of 14 AH patients (28%) had a VFD at 10 degrees from center and 11/14 (78%) had VFD at 40 degrees. One of 15 ATL patients (7%) had a VFD at 10 degrees from center and 11/15 (73%) had VFD at 40 degrees. There was no significant difference between surgery types. CONCLUSIONS: AH in this study was associated with a significant number of VFD. No significant difference was found between the frequency of VFD produced from AH and ATL. The mechanism of injury is due to direct trauma to the optic radiations while accessing the mesial temporal structures. Because all patients in the study were asymptomatic for VFD, it remains to be determined whether these VFD are clinically significant.
OBJECTIVE: To evaluate and identify the incidence of visual field defects (VFD) after anterior temporal lobectomy (ATL) versus amygdalohippocampectomy (AH). VFD occur frequently after ATL and are usually superotemporal quadrantanopias. Little is known about the incidence of VFD after AH and this surgical method offers the possibility of a seizure-free survival without visual loss. METHODS:Patients with similar characteristics were examined. All patients had intractable seizures and mesial temporal sclerosis, small tumors localized to only the uncus, amygdala, or hippocampus, or no known pathology. Postoperative kinetic field testing using the I4e isopter on a Goldmann perimeter was performed 30 days or more after surgery. RESULTS: Of 29 patients examined, 14 underwent AH and 15 had ATL. Four of 14 AHpatients (28%) had a VFD at 10 degrees from center and 11/14 (78%) had VFD at 40 degrees. One of 15 ATL patients (7%) had a VFD at 10 degrees from center and 11/15 (73%) had VFD at 40 degrees. There was no significant difference between surgery types. CONCLUSIONS:AH in this study was associated with a significant number of VFD. No significant difference was found between the frequency of VFD produced from AH and ATL. The mechanism of injury is due to direct trauma to the optic radiations while accessing the mesial temporal structures. Because all patients in the study were asymptomatic for VFD, it remains to be determined whether these VFD are clinically significant.
Authors: H Clusmann; T Kral; E Fackeldey; I Blümcke; C Helmstaedter; J von Oertzen; H Urbach; J Schramm Journal: J Neurol Neurosurg Psychiatry Date: 2004-11 Impact factor: 10.154
Authors: T Taoka; M Sakamoto; H Nakagawa; H Nakase; S Iwasaki; K Takayama; K Taoka; T Hoshida; T Sakaki; K Kichikawa Journal: AJNR Am J Neuroradiol Date: 2008-05-01 Impact factor: 3.825
Authors: João Paulo Sant Ana Santos de Souza; Gabriel Ayub; Pamela Castro Pereira; José Paulo Cabral Vasconcellos; Clarissa Yasuda; Andrei Fernandes Joaquim; Helder Tedeschi; Brunno Machado Campos; Fernando Cendes; Enrico Ghizoni Journal: Neuroradiology Date: 2019-09-07 Impact factor: 2.804
Authors: M Yogarajah; N K Focke; S Bonelli; M Cercignani; J Acheson; G J M Parker; D C Alexander; A W McEvoy; M R Symms; M J Koepp; J S Duncan Journal: Brain Date: 2009-05-21 Impact factor: 13.501