Faculty Collaboration Database

Magnetic resonance analysis of postsurgical temporal lobectomy. J Neuroimaging 2001 Jul;11(3):243-7

Date

07/21/2001

Pubmed ID

11462289

DOI

10.1111/j.1552-6569.2001.tb00041.x

Scopus ID

2-s2.0-0034943244 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

BACKGROUND AND PURPOSE: The effect of temporal lobe transection area, volume of postoperative gliosis, and surgical technique on patients' seizure-free outcome is unknown. The authors studied the effects of these variables on patients' seizure-free outcome.

METHODS: A retrospective review of magnetic resonance imaging examinations acquired 3 to 18 months after temporal lobe resection was carried out for 18 patients with intractable temporal lobe seizures and known postsurgical outcomes for more than 2 years. The total volume of radiologically probable gliosis evident on axial proton-density-weighted images was calculated for each patient using software on an independent console. The total area of temporal lobe surface transected by the scalpel was calculated as well, using sagittal T1-weighted images. The total volume of gliosis, the total area of transected temporal lobe, and the specific type of surgery (sparing vs no sparing of the superior temporal gyrus) were then correlated with the postsurgical outcome of the patients. An examiner with no prior knowledge of the patients' postsurgical outcomes carried out the above calculations and measurements. The patients' postoperative outcome was defined using Engel classifications, and patients were divided into 2 groups: group A with Engel class 1 (n = 9) and group B with Engel classes 2-4 (n = 9).

RESULTS: The mean volumes of postoperative gliosis were not significantly different between group A (3592.3 mm3) and group B (4270 mm3). The mean area of transected temporal lobe was also similar between group A (1865.2 mm2) and group B (1930 mm2). With regard to surgical technique, there were 5 patients who had the superior temporal gyrus resected and 13 who did not. Eighty percent of patients with the superior temporal gyrus resected were Engel class 1 or 2, whereas only 20% were of Engel class 3 or 4.

CONCLUSIONS: The authors found no clear association between postoperative outcome and residual temporal lobe gliosis, the surgical technique, or the total area of temporal lobe transected by the scalpel.

Author List

Alsaadi TM, Ulmer JL, Mitchell MJ, Morris GL, Swanson SJ, Mueller WM

Authors

Wade M. Mueller MD Professor in the Neurosurgery department at Medical College of Wisconsin
Sara J. Swanson PhD Chief, Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Electroencephalography
Epilepsy, Temporal Lobe
Female
Gliosis
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Pilot Projects
Postoperative Care
Retrospective Studies
Temporal Lobe
Treatment Outcome