Temporal lobe epilepsy tle is the most common form of medically intractable epilepsy. Core techniques in operative neurosurgery 2nd edition. For patients with intractable mtle, an anterior temporal lobectomy and amygdalohippocampectomy atl offers the possibility of seizure freedom with reduced reliance on antiepileptic medications. Cohengadol goodman campbell brain and spine, department of neurological surgery, indiana university school of medicine, indianapolis. Surgical techniques for the treatment of temporal lobe. Transsylvian selective amygdalohippocampectomy for treatment of. We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Concise and easy to read, it uses a highly illustrated, stepbystep approach to. Selective amygdalohippocampectomy sah represents an approach to the mesiobasal temporal structures that is as effective as atl in selected patients, has the potential to minimize neocortical injury and its neurological sequelae, and is.
Neurosurgery, or neurological surgery, is the medical specialty concerned with the prevention, diagnosis, surgical treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spinal cord, peripheral nerves, and cerebrovascular system. Epilepsy is a common neurological disorder affecting an estimated 1% of the population, about 20 to 30% of which experience seizures inadequately controlled by medical therapy alone. Selective amygdalohippocampectomy operative anatomy and. Thieme medical publishers operative techniques in epilepsy. To report our institutional seizure and neuropsychological outcomes for a series of patients with mesial temporal lobe epilepsy mtle undergoing anterior temporal lobectomy atl or selective amygdalohippocampectomy selah between 2004 and 2011. It consists of the removal of the hippocampus, which has a role in memory, spatial awareness, and navigation, and the amygdalae, which have a role in the processing and memory of emotional reactions, both structures forming part of the limbic system of the brain. Surgical morbidity included hemiparesis capsular hypertensive hemorrhage 24 hours after surgery, 1 patient, verbal memory worsening 2 patients, and quadrantanopia permanent in 2 patients, transient in 1. Keyhole corticoamygdalohippocampectomy for mesial temporal lobe epilepsy pengfan yang abstract keyhole corticoamygdalohippocampectomy is a modification of conventional trans middle temporal gyrus selective amygdalohippocampectomy. The approach to removing the mesial temporal lobe varies from center to. Epilepsy surgery can be an effective epilepsy treatment for patients whose seizures do not respond to best medical therapy.
Ahe amygdalohippocampectomy epilepsy surgery procedure. Anteromesial temporal lobectomy thieme medical publishers. Niemeyer and bello described a transventricular amygdalohippocampectomy in which a corticotomy was placed in the middle temporal gyrus and access to the ventricle was obtained by aspiration of the white matter. Kop operative techniques in epilepsy surgery av gordon h baltuch, arthur cukiert pa. Central region 12 posterior quadrant resections surgery of the insula. In contrast to standard anterior temporal lobectomy, resection of unaffected tissue is limited, although it achieves equal seizure outcomes in selected patients. Oguz cataltepe and john weaver thieme medical publishers. Techniques for performing tracheostomy charles g durbin jr md faarc introduction history of tracheostomy percutaneous tracheostomy techniques of performing an open or surgical tracheostomy percutaneous dilational tracheostomy choosing a technique summary one of the most commonly performed procedures in the critically ill, tracheostomy has been. Transsylvian translimen insula approach to the mediobasal temporal lobe region. Surgery for medically intractable epilepsy remains an underutilized treatment. Important aspects of the subtemporal approach include a low temporal keyhole craniotomy, use of image guidance, preservation of the tentorium, incision in the fusiform gyrus, and subpial, en bloc resection of the hippocampus. Read book atlas of neurosurgical techniques brain books if youd like more information on how the process works. The transcortical approach is technically simpler, with the drawback of damage to the lateral temporal neocortex. A number of different surgical techniques are effective for treatment of drugresistant medial temporal lobe epilepsy.
For patients with temporal lobe epilepsy, selective amygdalohippocampectomy sah has emerged as a viable alternative to standard anterior temporal lobectomy. Niemeyer described the innovative surgical technique he called transventricular amygdalahippocampectomy and presented the rational for a selective approach to surgery for temporal lobe epilepsy at the international colloquium on temporal lobe epilepsy in 1957 that took place at the national institutes of health. Surgical techniques for the treatment of temporal lobe epilepsy. This book brings to date the reports and conclusions from the montreal neurological institutes clinical, physiological, and neurosurgical studies of epilepsy, and is, in a sense, a sequal to. Microsurgical techniques in temporal lobe epilepsy.
The data presented about the localization of the head of the hippocampus 34 cm from the anterior temporal tip may have important implications regarding the extent of temporal neocortical resection necessary to perform an amygdalohippocampectomy. From patient preparation to hand washing, from equipment to basic surgical procedures, this highly practical manual by drs. Dec 19, 2018 background this article discusses the indications for selective amygdalohippocampectomy sah and the surgical techniques used to perform it. Josephs hospital and medical center, phoenix, arizona. May 02, 2015 video shows what amygdalohippocampectomy means. Addressing barriers to surgical evaluation for patients with epilepsy. Surgical removal of the hippocampus, often used as a treatment for epilepsy amygdalohippocampectomy meaning. Selective amygdalohippocampectomy as a surgical treatment of. One surgical procedure for the treatment of temporal lobe epilepsy is selective amygdalohippocampectomy sah. Transcortical selective amygdalohippocampectomy technique.
Pial boundary overlying the suprasellar cistern carotid artery, third cranial nerve uncus of the temporal lobe. This book provides surgeons interested in minimally invasive abdominal surgery with the most recent techniques in laparoscopic surgery. Mar 22, 2012 neuromodulation, another treatment, involves a combination of neurostimulation, drug delivery, neuronal tissue transplants, and gene therapy. Apr 24, 2020 this site uses akismet to reduce spam. Surgery books download thousands of surgery books pdf. Traditional surgical procedures, such as the combined resection of the temporal pole with amygdalohippocampectomy using a cortical approach allow tissue slice preparations for electrophysiological recordings in temporal cortex and hippocampal tissue fig. Amygdalohippocampectomy an overview sciencedirect topics. Part of the advances and technical standards in neurosurgery book series.
Neuropsychological effects associated with temporal. Brain sciences free fulltext surgical considerations. Transsylvian selective amygdalohippocampectomy for. To view all 5000 books, please click the button bewlow.
The major aspects of reporting this series are to discuss the criteria which must be met before considering surgery, the need to establish a proper diagnosis and the need for immaculate surgical techniques. Procedurerelated temporal infarct after retractorless. The fda has approved neurostimulation of the vagus nerve for the treatment of refractory epilepsy. Pdf selective amygdalohippocampectomy researchgate.
Reviewed by carol scottconner, md, phd, mba university of iowa hospitals and clinics. Anteromedial temporal lobectomy the neurosurgical atlas. Overview of common cortical stimulation and mapping techniques including magnetic and electrical stimulation modalities, functional mri, and the wada test. Aman coonar this heavily revised second edition of this book provides a comprehensive overview of both common and rarely performed thoracic surgical techniques. External cortical landmarks for localization of the. Amygdalohippocampectomy operative anatomy and surgical technique. Distinguished pioneers in the field provide comprehensive coverage of the range of operative approaches, helping clinicians to thoroughly prepare for surgery. Several surgical approaches have been described for resecting epileptic foci arising from the medial temporal lobe in children with medically refractory mesial tle of unilateral origin. Second, the mtg is routinely removed during surgery for mtle and thus no modification to surgical technique is required to obtain this tissue valiante 2009. Advances in electrophysiology and neuroimaging have led to a more precise localization of the epileptogenic zone within the temporal lobe. Although some of the terminology is inexact, and the details of the surgical technique vary somewhat across centers especially regarding the exact location of the corticectomy, the reported results are very similar. Selective amygdalohippocampectomy sah is a surgical treatment option for patients with medically intractable mesial temporal lobe epilepsy. An indispensable, singlevolume resource on stateoftheart epilepsy procedures from renowned international experts.
Several surgical approaches to the mesial temporal structure have been reported in the literature 4, 6, 7, 9, 1114. We describe the most frequently used approaches and surgical techniques for removal of both the lateral and mesial temporal lobe structures in the treatment of medically intractable temporal lobe epilepsy tle due to mesial temporal sclerosis. Until now, surgical orientation has been achieved through exposure of anatomic landmarks. The definitive guide to surgical management of epilepsy in pediatric patients. Selective amygdalohippocampectomy is an effective operation for mesial temporal lobe epilepsy due to mesial temporal sclerosis, particularly on the left side. Amygdalohippocampectomy is a surgical procedure for the treatment of epilepsy. Kavoussi, provides students, residents, and clinicians with a firm foundation in the core techniques and skills required for the operating room environment. Applications for selective amygdalohippocampectomy and depth electrode placement. Despite the variability in surgical techniques and in the extent of resection, the overall. The neurosurgical atlas is committed to promoting neurosurgical education free of charge. Operative techniques in epilepsy surgery is an essential guide to the latest techniques and therapeutic strategies for the surgical management of patients with epilepsy. Subsequently, the sylvian fissure was widely opened under 40. The text includes different topics covering a big variety of medical conditions with uptodate information.
A new surgical technique for temporal lobe epilepsy 9 hippocampal transection 10 frontal lobe resection in refractory epilepsy 11 cortical resection. We compared changes in neuropsychological scores in patients who underwent tl n 91 or ah n 15, and had passed or failed the wada test. It consists of the removal of the hippocampus, which has a role in memory, spatial awareness, and navigation, 1 and the amygdalae, which have a role in the processing and memory of emotional reactions, 2 both structures forming part of the limbic system of the brain. Transsylvian selective amygdalohippocampectomy the. Epilepsy is a common condition that affects nearly 1% of the worlds population. Temporal lobe resection in epilepsy surgery is not a standard technique.
A temporal craniotomy is performed exposing the sylvian fissure fig. The book and accompanying videos provide good value and should be helpful for medical students and possibly some firstyear residents. Microsurgical anatomy of the transsylvian translimen insula. Get stepbystep, expert guidance on fundamental procedures in neurosurgery both in print and on video. Subtemporal transparahippocampal amygdalohippocampectomy. Neuromodulation, another treatment, involves a combination of neurostimulation, drug delivery, neuronal tissue transplants, and gene therapy. A recent metaanalysis showed that anteromesial temporal resection confers a higher chance of seizure freedom compared to selective amygdalohippocampectomy josephson et al. Operative approaches to the amygdala and hippocampus that previously have been reported include. Surgical anatomy of the temporal lobe for epilepsy surgery. Transsylvian selective amygdalohippocampectomytechnique. Distinguished pioneers in the field provide comprehensive coverage. The most common and wellcharacterized focal epilepsy syndrome is medial mesial temporal lobe epilepsy mtle. Transcortical selective amygdalohippocampectomy technique through the middle temporal gyrus revisited. This is an alternative to the most common surgery to treat seizures in adults, anterior temporal lobectomy.
Search the worlds most comprehensive index of fulltext books. Close this message to accept cookies or find out how to manage your cookie settings. In recent years, approaches ranging from open surgery to minimally invasive techniques have been leveraged to improve daily functioning and quality of life in people struggling with painful, highly disruptive, andor. Clip reconstructions and bypass techniques laligam sekhar. Operative techniques in epilepsy surgery gordon h baltuch. The surgical technique of retractorless transsylvian sah used in this study was developed by yasargil.
The modern era of surgical epilepsy therapy probably began with the work of victor horsley in 1886, yet the role of surgery in the treatment of the epilepsies is only now becoming more widely. Vertebral compression fractures in osteoporotic and pathologic bone. To describe a novel operative technique for treatment of temporal lobe epilepsy and its clinical results. Operative techniques in epilepsy surgery gordon baltuch. An anatomical study laboratory investigation baran bozkurt, ricardo da silva centeno, feres chaddadneto, marcos devanir silva da costa, marcelo augusto acosta goiri, ali karadag, bekir tugcu, talat cem ovalioglu, necmettin tanriover, serdar. Transsylvian selective amygdalohippocampectomy for treatment of medial temporal lobe epilepsy. Handbook of surgical sutures and knots olajumoke alice ogunji zainab jimoh isa ngbede ogunfowora olumide taiwo em sa c sm u. As a general rule, a procedure is considered surgical when it involves cutting of a persons tissues or closure of a previously sustained wound. Oliver a, cukiert a, andermann f 1993 transsulcal selective amygdalohippocampectomy. Despite the variability in surgical techniques and in the extent of resection, the overall outcomes of different tle surgeries are similar. Operative time was reduced by about 30 minutes 15% on average with this technique. Sep 30, 2018 a number of different surgical techniques are effective for treatment of drugresistant medial temporal lobe epilepsy. Download ebook advanced techniques in limb reconstruction surgery pdf free download medical books free as a result of recent advances in surgical techniques and implant technology it is now possible to perform limb reconstruction in patients with a range of congenital, posttraumatic, and postinfection pathologies. Surgery is a invasive technique with the fundamental principle of physical intervention on organsorgan systemstissues for diagnostic or therapeutic reasons.
Transsylvian selective amygdalohippocampectomy for treatment. Common surgical procedures for the treatment of epilepsy anterior temporal lobectomy amygdalohippocampectomy extratemporal resection lesionectomy corpus callosotomy hemispherectomy and large multilobar resections intracranial invasive monitoring intracranial monitoring is not used as a routine part of the evaluation for surgical candidacy. Core techniques in operative neurosurgery, 2nd edition, provides the tools needed to hone existing surgical skills and learn new techniques, helping you minimize risk and achieve optimal outcomes for every procedure. Jul 31, 2019 surgical atlas of spinal operations by jason eck author, alexander r. Surgical orientation is achieved by revealing key anatomic points. This book is an important contribution to the current knowledge database on epilepsy surgery. Amygdalohippocampectomy ah is an accepted surgical option for treatment of medically refractory mesial temporal lobe epilepsy. Indications, investigative technique and results springerlink. Practical coverage of the innovative surgical techniques for epilepsy.
With selective amygdalohippocampectomy, neurosurgeons remove parts of the amygdala and most of the hippocampus. This book brings to date the reports and conclusions from the montreal neurological institutes clinical, physiological, and neuro surgical studies of epilepsy, and is, in a sense, a sequal to. Anterior temporal lobectomy with amygdalohippocampectomy atlah has been shown to be more efficacious than continued medical therapy in a randomized, controlled trial 5. A two piece orbitozygomatic craniotomy was performed in all three injected cadaveric heads. Subtemporal amygdalohippocampectomy for treating medically. Division of neurological surgery, barrow neurological institute, st. Discover book depositorys huge selection of general surgery books online. The most common surgical procedure for the mesial temporal lobe is the standard anterior temporal resection or what is commonly called the anterior temporal lobectomy. Selective amygdalohippocampectomy sankhe ms, govindappagari. The mission of the epilepsy foundation is to lead the fight to overcome the challenges of living with epilepsy and to accelerate therapies to stop seizures, find cures, and save lives. The refined technique of the handling and uniting the tissues in the case of manual skills is attainable by many practices, and the good surgeon works on the.
Resective surgery is the most effective treatment for tle. To compare the neuropsychological effects of temporal lobectomy tl and amygdalohippocampectomy ah, depending on whether the patients had passed or failed the wada test. Neurosurgery operative techniques in epilepsy surgery. Background this article discusses the indications for selective amygdalohippocampectomy sah and the surgical techniques used to perform it. Of these, transsylvian selective amygdalohippocampectomy sa, which was originally developed to maximize temporal lobe preservation, is arguably the most technically demanding to perform. Mts is the most common pathologic finding in patients with mtle and this cohort is a distinctive group with excellent surgical outcome radhakrishnan et al. Surgical technique positioning the patient was placed under general anesthesia. Brain sciences free fulltext surgical considerations of. Keyhole corticoamygdalohippocampectomy for mesial temporal. They then continue to neglect the good surgical results obtained if the patients are well screened.
Neurosurgical operative atlas 3rd edition pdf for free. Principles for managing cavernous malformations in eloquent. Atlas of neurosurgical techniques brain bypass techniques for complex intracranial aneurysms jacques morcos. Grand roundsanteromedial temporal lobectomy and selective.