Multiple factors such as the width of the cortical area involved, amplitude of ictal discharges and degree of synchronization of electrical potentials play important roles in the appearance of ictal EEG recordings, and the relationship between ictal EEG and ECoG is not straightforward.

Tumor removal via the retrosigmoid lateral suboccipital approach may provide some chance for improvement of tinnitus in patients with VSs; however, neither cochlear nerve resection nor useful hearing preservation affects the postoperative development of tinnitus.

Subependymal germinal matrix with intraventricular hemorrhage (GMIVH) is a common complication associated with delivery in preterm neonates but has rarely been observed in the fetus. Clinical and neuroradiological findings of 5 patients who were diagnosed as having fetal GMIVH with prenatal ultrasonographic examinations (US) and MRI, and postnatal MRI were reviewed retrospectively. During a seemingly uneventful pregnancy, fetal GMIVH occurred at approximately 30–33 weeks of gestation, with the absence of any known factor predisposing to fetal hemorrhage. Routine obstetric US revealed an intraventricular lesion in the enlarged ventricles. Prenatal MRI clearly demonstrated parenchymal change such as intracerebral hematoma adjacent to the subependymal and intraventricular hematoma, and periventricular leukomalacia as well as GMIVH. Although patients without parenchymal destruction (hemosiderin deposit alone) had a favorable neurodevelopmental outcome, encephalomalacia and periventricular leukomalacia contributed to long-term neurodevelopmental deficits. Evaluating parenchymal damage with prenatal MRI can therefore help to predict neurodevelopmental prognosis of the fetus with GMIVH.

Based on these histological observations, complete tumor resection can be achieved by removal of both tumor parenchyma and tumor capsule when a clear border between the tumor capsule and facial or cochlear nerve fibers can be identified intraoperatively. Conversely, when a severe adhesion between the tumor and facial or cochlear nerve fibers is observed, dissection of the vestibular nerve-tumor interface (the subcapsular or subperineurial dissection) is recommended for preservation of the functions of these cranial nerves.

Summary Purpose:  To examine the utility of fluid‐attenuated inversion recovery (FLAIR) imaging and three‐dimensional short tau inversion recovery (3DSTIR) imaging using a 3‐Tesla (3‐T) magnetic resonance (MR) imager in the preoperative evaluation of hippocampal sclerosis (HS). Methods:  Thirteen patients with intractable medial temporal lobe epilepsy who underwent anterior temporal lobectomy with amygdalohippocampectomy were studied. MR images were obtained twice, once with a 1.5‐T imager and once with a 3‐T imager. The extent of hippocampal resection was determined according to the findings on intraoperative hippocampal electroencephalography. We compared the diagnostic utility of FLAIR for HS between 1.5‐T and 3‐T MR imaging. In addition, the relationship between the existence of hypointense areas in the hippocampus (HIAs) on 3DSTIR and the severity of HS pathology (as evaluated using Watson’s grading) was examined. The relationship between postoperative seizure outcome and postoperatively remaining HIAs was also evaluated. Results:  There was no difference between FLAIR images from 1.5‐T and 3‐T imaging in the detection of HS. With 3DSTIR, an HIA in unilateral hippocampus was observed in all of the nine cases exhibiting severe pathologic HS (Watson’s grade III–V). In seven cases with HIA, the extent of hippocampal resection was smaller than the HIAs. Every case showed good seizure outcome (Engel’s class I and II). Discussion:  In the diagnosis of HS, no substantial difference was noted between 1.5‐T and 3‐T MR imaging. However, 3DSTIR using 3‐T MR imaging is useful for evaluating the extent of HS, although postoperative HS remnants are not correlated with surgical outcomes.