Visual Field Defects After Temporal Lobectomy

Björk, Åke; Kugelberg, Eric

doi:10.1111/j.1755-3768.1957.tb05407.x

Cited by 20 publications

(16 citation statements)

References 8 publications

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“…There was no consistency among the reported locations, which varied from 30 to 45 mm posterior to the TP. [7][8][9] In 1954, Penfield 10 stated that resections extending Ͻ6 cm posterior to the tip of the TP were "not likely" to result in VFD. These studies relied on the surgeon to subjectively estimate the resection size and the anterior extent of the Meyer loop in the absence of neuroimaging.…”

Section: Surgical Studiesmentioning

confidence: 99%

Challenges of the Anatomy and Diffusion Tensor Tractography of the Meyer Loop

Mandelstam

2012

AJNR Am J Neuroradiol

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SUMMARY:This review addresses the complex and often controversial anatomy of the anterior bundle of the OR, also known as the Meyer loop. Before the advent of MR imaging, 2 main types of studies attempted to ascertain the "safe" distance for anterior temporal lobe resection to avoid postsurgical VFDs. There were those based first on postoperative VFD correlation and second on anatomic dissection studies. In the past decade, noninvasive diffusion MR imagingϪbased tractography techniques have been developed in an attempt to elucidate white matter connectivity. Although many of these techniques are still experimental, there are some clinical situations for which they may prove to be very helpful if properly performed and validated. The motivation for this review was to improve the outcome of patients with TLE undergoing temporal lobectomy: Would having anatomic information about the OR available to the neurosurgeon decrease the risk of postsurgical VFDs?ABBREVIATIONS: ATL ϭ anterior temporal lobectomy; CSD ϭ constrained spherical deconvolution; DT-FT ϭ diffusion tensor fiber tractography; DTI ϭ diffusion tensor imaging; FA ϭ fractional anisotropy; LGB ϭ lateral geniculate body; LGN ϭ lateral geniculate nucleus; OR ϭ optic radiations; TLE ϭ temporal lobe epilepsy; TP ϭ temporal pole; VFD ϭ visual field deficit T emporal lobectomy has become a common and successful form of epilepsy surgery, which can stop the occurrence of TLE in most appropriate patients who are refractory to medical treatment. A common complication of ATL is the occurrence of a postoperative VFD due to disruption of the OR, specifically the anterior bundle, the Meyer loop. Unfortunately, the extent of a postoperative VFD cannot be accurately predicted by conventional MR imaging or from the extent of the resection performed. Risk of damage to the OR is substantial because the tracts are not separately visible under the operating microscope. As the Meyer loop transmits visual information from the contralateral superior field of both eyes, damage will cause homonymous superior quadrantanopia.

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Section: Surgical Studiesmentioning

confidence: 99%

Challenges of the Anatomy and Diffusion Tensor Tractography of the Meyer Loop

Mandelstam

2012

AJNR Am J Neuroradiol

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“…The lateral transtemporal approach transects the upper or middle temporal gyrus, with potential damage to the fibers of the optical radiation located on the lateral wall and roof of the temporal horn, resulting in superior quadrantanopsia in up to 50% of patients 19,20,21,22 . Most techniques of selective amygdalohippocampectomy require an extensive craniotomy, with additional morbidity.…”

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confidence: 99%

“…In the outpatient evaluations, patients did not spontaneously report any visual changes, and no field-related alterations were detected in the visual field examinations. Conversely, patients operated on with conventional techniques have had visual field disorders due to injury to the optic radiation 20,22 . With this technique, lateral temporal neocortex white fiber lesions are minimized ( Figure 13).…”

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confidence: 99%

Transtemporal amygdalohippocampectomy: a novel minimally-invasive technique with optimal clinical results and low cost

Flores

Sanders

Figueiredo

et al. 2017

Arq. Neuro-Psiquiatr.

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Mesial temporal sclerosis creates a focal epileptic syndrome that usually requires surgical resection of mesial temporal structures. Objective: To describe a novel operative technique for treatment of temporal lobe epilepsy and its clinical results. Methods: Prospective case-series at a single institution, performed by a single surgeon, from 2006 to 2012. A total of 120 patients were submitted to minimally-invasive keyhole transtemporal amygdalohippocampectomy. Results: Of the patients, 55% were male, and 85% had a right-sided disease. The first 70 surgeries had a mean surgical time of 2.51 hours, and the last 50 surgeries had a mean surgical time of 1.62 hours. There was 3.3% morbidity, and 5% mild temporal muscle atrophy. There was no visual field impairment. On the Engel Outcome Scale at the two-year follow-up, 71% of the patients were Class I, 21% were Class II, and 6% were Class III. Conclusion: This novel technique is feasible and reproducible, with optimal clinical results.

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“…A via trans-cisternal requer a dissecação das cisternas basais e manipulação das estruturas neurais e vasculares do hiato tentorial (Figueiredo et al, 2010) (Figura 3). Para executar a via transtemporal lateral torna-se necessário transfixar o giro temporal superior ou médio, o que implica no risco potencial de lesão das fibras da radiação óptica localizadas na parede lateral e no teto do corno temporal e, consequentemente na indução de quadrantanopsia homônima superior (Meyer, 1907;Bjork e Kugelberg, 1957;Bender, 1981;Babb et al, 1982;Egan et al, 2000;Pujari et al, 2008) reportadas em até 50% dos doentes assim operados (Meyer, 1907;Egan et al, 2000) (Figura 4 A e B).…”

Section: Figura 1 -Fotografias Das Etapas Da Lobectomia Temporal Anteunclassified

“…Os doentes submetidos a tratamento com as técnicas convencionais frequentemente apresentam alteração do exame campimétrico (quadrantanopsia homonima superior em até 50% dos casos) (Meyer, 1907;Bjork e Kugelberg, 1957;Bender, 1981;Babb et al, 1982;Egan et al, 2000;Pujari et al, 2008).…”

Section: Figura 14 -Fotografia De Uma Doente No Período Pós-operatóriunclassified

Amigdalo-hipocampectomia transtemporal, utilizando acesso mínimo (key-hole): avaliação da técnica cirúrgica e dos resultados

Flores¹

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Visual Field Defects After Temporal Lobectomy

Cited by 20 publications

References 8 publications

Challenges of the Anatomy and Diffusion Tensor Tractography of the Meyer Loop

Challenges of the Anatomy and Diffusion Tensor Tractography of the Meyer Loop

Transtemporal amygdalohippocampectomy: a novel minimally-invasive technique with optimal clinical results and low cost

Amigdalo-hipocampectomia transtemporal, utilizando acesso mínimo (key-hole): avaliação da técnica cirúrgica e dos resultados

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