Microvascular Anatomy of the Medial Temporal Region

Fernández-Miranda, Juan C.; Oliveira, Evandro de; Rubino, Pablo; Wen, Hung Tzu; Rhoton, Albert L.

doi:10.1227/01.neu.0000381003.74951.35

Cited by 50 publications

(64 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The dominant feeding arteries vary with nidus location in the lateral temporal lobe, and may be temporopolar, anterior temporal, middle temporal, posterior temporal, or tem-porooccipital arteries as the location shifts from anterior to posterior. 7,18 The MCA feeding arteries emanate from the sylvian fissure and feed the nidus along its superior border. These are often large-caliber arteries that require aneurysm clips to occlude or temporary clips to stop flow during cauterization.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have applied this classification (like Nagata et al 15 in a surgical series of 26 temporal patients with lobe AVMs), but it lacks intuitiveness and the distinctions between subtypes are poorly defined. Rhoton and colleagues 3,7,18 described a more intuitive approach based on the 4 temporal lobe surfaces: lateral, medial, ba sal, and sylvian fissure. Rhoton, de Oliveira, and colleagues devoted much of their attention to AVMs in the medial temporal region rather than to temporal lobe AVMs as a whole.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Temporal lobe arteriovenous malformations: anatomical subtypes, surgical strategy, and outcomes

Canals

Rodríguez-Hernández

Young

et al. 2013

JNS

View full text Add to dashboard Cite

Object Descriptions of temporal lobe arteriovenous malformations (AVMs) are inconsistent. To standardize reporting, the authors blended existing descriptions in the literature into an intuitive classification with 5 anatomical subtypes: lateral, medial, basal, sylvian, and ventricular. The authors’ surgical experience with temporal lobe AVMs was reviewed according to these subtypes. Methods Eighty-eight patients with temporal lobe AVMs were treated surgically. Results Lateral temporal lobe AVMs were the most common (58 AVMs, 66%). Thirteen AVMs (15%) were medial, 9 (10%) were basal, and 5 (6%) were sylvian. Ventricular AVMs were least common (3 AVMs, 3%). A temporal craniotomy based over the ear was used in 64%. Complete AVM resection was achieved in 82 patients (93%). Four patients (5%) died in the perioperative period (6 in all were lost to follow-up); 71 (87%) of the remaining 82 patients had good outcomes (modified Rankin Scale scores 0–2); and 68 (83%) were unchanged or improved after surgery. Conclusions Categorization of temporal AVMs into subtypes can assist with surgical planning and also standardize reporting. Lateral AVMs are the easiest to expose surgically, with circumferential access to feeding arteries and draining veins at the AVM margins. Basal AVMs require a subtemporal approach, often with some transcortical dissection through the inferior temporal gyrus. Medial AVMs are exposed tangentially with an orbitozygomatic craniotomy and transsylvian dissection of anterior choroidal artery and posterior cerebral artery feeders in the medial cisterns. Medial AVMs posterior to the cerebral peduncle require transcortical approaches through the temporooccipi tal gyrus. Sylvian AVMs require a wide sylvian fissure split and differentiation of normal arteries, terminal feeding arteries, and transit arteries. Ventricular AVMs require a transcortical approach through the inferior temporal gyrus that avoids the Meyer loop. Surgical results with temporal lobe AVMs are generally good, and classifying them does not offer any prediction of surgical risk.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Temporal lobe arteriovenous malformations: anatomical subtypes, surgical strategy, and outcomes

Canals

Rodríguez-Hernández

Young

et al. 2013

JNS

View full text Add to dashboard Cite

show abstract

“…For a better understanding, Fernández-Miranda et al divided this surface into three segments: anterior, middle, and posterior [6]. The anterior segment begins where the rhinal sulcus turns superiorly at the anterior edge of the uncus and ends at the posterior limit of the uncus; the medial segment begins at the posterior edge of the uncus and ends at the level of the quadrigeminal plate; the posterior segment begins at this point and ends at the calcarine point where the parietooccipital and calcarine sulci join (Figure 1(d)).…”

Section: Neural Featuresmentioning

confidence: 99%

“…The anatomy of the temporal horn and atrium will be discussed with their relationship to the three parts of the MTR [6, 34]. …”

Section: Neural Featuresmentioning

confidence: 99%

See 1 more Smart Citation

Microsurgical Anatomy of the Temporal Lobe and Its Implications on Temporal Lobe Epilepsy Surgery

Küçükyürük

Richardson

Wen

et al. 2012

Epilepsy Research and Treatment

Self Cite

View full text Add to dashboard Cite

Objective. We review the neuroanatomical aspects of the temporal lobe related to the temporal lobe epilepsy. The neuronal, the ventricular, and the vascular structures are demonstrated. Methods. The previous articles published from the laboratory of the senior author are reviewed. Results. The temporal lobe has four surfaces. The medial surface has a complicated microanatomy showing close relation to the intraventricular structures, such as the amygdala or the hippocampus. There are many white matter bundles in the temporal lobe showing relation to the extra- and intraventricular structures. The surgical approaches commonly performed to treat temporal lobe epilepsy are discussed under the light of these data. Conclusion. A thorough knowledge of the microanatomy is necessary in cortical, subcortical, and intraventricular structures of the temporal lobe to achieve better results.

show abstract

Vessel distance mapping: a novel methodology for assessing vascular‐induced cognitive resilience

Garcia-Garcia

Mattern

Vockert

et al. 2022

Alzheimer's & Dementia

View full text Add to dashboard Cite

BackgroundThe association between cerebral blood supply and cognition has gained increasing interest, considering the remarkable anatomical variability of the circle of Willis. Thus, qualitative classifications of the arteries contributing to the hippocampal supply has been performed in previous studies to determine whether the additional presence of vessels might translate into cognitive differences and cerebral structural changes when coexisting with vascular pathology, to the extent of constituting a cognitive reserve. Nevertheless, the promising results in these regards are not without controversy. Hence, Vessel Distance Mapping (VDM) is here introduced, in order to ascertain the correlation of VDM‐metrics with each other and with cognitive status, as well as to elucidate which metrics have the greatest impact on cognition.MethodA battery of cognitive tests was used (including ADAScog and MoCA) in 51 subjects (71 ± 8.5yrs) with (n=20) and without (n=31) cerebral small vessel disease. Their hippocampal‐related vessels were manually segmented by using high‐resolution 7T Time‐of‐Flight‐MRI. Vessel distance maps were generated by computing the distances of each voxel to its nearest vessel, obtaining 3 VDM‐metrics: global‐VDM (vessel density surrogate), VS‐VDM (vessel‐specific supply), and COMD (distance to the center of mass, reflecting vessel distribution). Hippocampal masks were used to assess the whole and subregional hippocampus. Regression models were applied for evaluating the interrelation among the metrics, and their association with cognition.ResultHigh correlations were observed for intra‐metric comparisons, as well as when comparing whole hippocampal vs. sub‐hippocampal metrics. Greater values of VDM‐metrics reflecting higher distances among vessels were associated with poorer cognitive outcomes only in subjects affected by vascular pathology (global‐VDM R²=0.7248, p=0.0054; COMD R²=0.7248, p=0.0013). Metrics revealing vascular distribution (p=0,0053) and density (p=0,0169) were the most influential on cognition, and in this context those for the whole hippocampus predominated over the subregional ones.ConclusionA mixed contribution of vessel distribution and density is proposed to confer cognitive resilience, in a way consistent with anatomical fundamentals and with previous research findings. VDM provides a new, structure‐driven approach on which to raise new questions supported by the statistical robustness of a quantitative method with potential clinical implications.

show abstract

Microvascular Anatomy of the Medial Temporal Region

Abstract: An understanding of the vascular variability of the MTR is essential for accurate microsurgical resection of MTR AVMs.

Cited by 50 publications

References 43 publications

Temporal lobe arteriovenous malformations: anatomical subtypes, surgical strategy, and outcomes

Temporal lobe arteriovenous malformations: anatomical subtypes, surgical strategy, and outcomes

Microsurgical Anatomy of the Temporal Lobe and Its Implications on Temporal Lobe Epilepsy Surgery

Vessel distance mapping: a novel methodology for assessing vascular‐induced cognitive resilience

Contact Info

Product

Resources

About