Transcortical selective amygdalohippocampectomy technique through the middle temporal gyrus revisited: An anatomical study laboratory investigation

Microsurgical anatomy of the amygdaloid body and its connections

“…In addiction, temporo-mesial structures are considered altered in 1/3 of patients affected by drug-resistant epilepsy. 2,3 These patients improve their conditions when submitted to surgical procedure of selective amygdalo-hippocampectomy. 4 The two main principles in epilepsy surgery are the removal of the epileptogenic tissue and the avoidance of surgical morbidity.…”

“…The trend is the development of approaches targeted to a more selective resection of the focus, sparing the most of the functional neural tissue and to improve the post-operative outcome. 2,3,4,5,6,7,8,9,34,35,36,37 For this reason nowadays a more selective amygdalo-hippocampectomy is preferred to a standard antero-lateral temporal lobectomy. Several approaches were developed to access the MTR, although each of them requires the sacrifice of the white matter bundles where the incision is performed.…”

“…7,8,46,50,61,93,94,95,96 We think that the three-dimensional visualization of the neuroanatomical structure is nowadays paramount for the education of a neurosurgeon that more and more needs to deal with an intricate three-dimensional brain network in order to obtain lower post-operative deficits. 2,3,4,5,6,7,8,9,34,35,36,37 Furthermore three-dimensional visualization of the white matter bundle contributes to the connectomic research. We sustain that every progress in surgery derives from a better knowledge of the anatomy.…”

Delineating functional segregations of the human middle temporal gyrus with resting‐state functional connectivity and coactivation patterns

“…Although the middle temporal gyrus (MTG) was traditionally regarded as a cytoarchitectonically homogeneous region (Brodmann, ), a large number of studies have demonstrated that it has various functions including language, emotion, memory, and social cognition (Friedman et al, ; Giraud et al, ; Goel, Gold, Kapur, & Houle, ; Hesling, Clement, Bordessoules, & Allard, ; McDermott, Petersen, Watson, & Ojemann, ; Mirz et al, ; Rizzolatti et al, ; Sato, Toichi, Uono, & Kochiyama, ; Whitney, Jefferies, & Kircher, ). Moreover, MTG impairments have been widely reported to be associated with various brain disorders, such as autism spectrum disorder (Assaf et al, ; Ogawa et al, ), major depression disorders (Cheng et al, ; Liu et al, ), bipolar disorder (Tian et al, ), obsessive–compulsive disorder (Fan et al, ), and temporal lobe epilepsy (Bozkurt et al, ). And the MTG was an optimal location for surgical treatment for temporal lobe epilepsy, known as trans‐MTG approach (Bozkurt et al, ; Bujarski et al, ; Wheatley, ).…”

“…Moreover, MTG impairments have been widely reported to be associated with various brain disorders, such as autism spectrum disorder (Assaf et al, ; Ogawa et al, ), major depression disorders (Cheng et al, ; Liu et al, ), bipolar disorder (Tian et al, ), obsessive–compulsive disorder (Fan et al, ), and temporal lobe epilepsy (Bozkurt et al, ). And the MTG was an optimal location for surgical treatment for temporal lobe epilepsy, known as trans‐MTG approach (Bozkurt et al, ; Bujarski et al, ; Wheatley, ). Given its functional diversity and close relationship with different brain disorders, building a fine‐grained functional atlas for MTG is crucial for delineating the functional specialization to guide the clinical accurate neurosurgery and treatment.…”