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Acta Neurochirurgica
Published in: Acta Neurochirurgica 1/2016

01-01-2016 | How I Do it - Neurosurgical Techniques

Anterior temporal lobectomy

Authors: Karl Schaller, Ivan Cabrilo

Published in: Acta Neurochirurgica | Issue 1/2016

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Abstract

Background

Anterior temporal lobectomy is the most established neurosurgical procedure for temporal lobe epilepsy. Here we describe this technique.

Method

A temporal craniotomy is performed flush with the middle fossa and exposing the Sylvian fissure. The posterior extent of resection is determined as 4.5 cm in the dominant temporal lobe and 5.5 cm in the nondominant one. The first stage consists of removing the lateral neocortex and part of the fusiform gyrus, parallel to the Sylvian fissure, while keeping the temporal horn as the medial limit in the coronal plane. Then, the amygdala, uncus, fimbriae, hippocampus and collateral eminence are identified, transected and resected with the parahippocampal gyrus to complete the procedure.

Conclusion

Knowledge of the temporomesial anatomy, including neurovascular structures around the brainstem, is essential to keep this procedure safe and effective.
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Metadata
Title
Anterior temporal lobectomy
Authors
Karl Schaller
Ivan Cabrilo
Publication date
01-01-2016
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 1/2016
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-015-2640-0

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