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The study of the mesial aspect has gained importance due to its anatomic complexity and its relationship to the surgical treatment of epilepsy. The aim of this paper is to do an anatomo-radiologic correlation of the morphology and topography of the mesial aspect of the temporal lobe, with its neurosurgical application in the treatment of diseases in the region. Eight (8) adult formalin fixed hemispheres with no pathologic signs were studied. On 4 of them sections within the 3 planes were performed (sagittal, coronal and axial), for radiologic correlation. On the remaining 4, dissection of the mesial region was done, in order to correlate the structures found during surgical approach to the region. Both in the cadaveric hemispheres and in the radiologic images, structures from the mesial region were identified, this included: collateral sulcus, rinal sulcus, parahippocampal gyrus, temporal uncus, hippocampal sulcus, hippocampus with its 3 sectors (head, body and tail), the inferior choroidal point and the collicular point that divides the hippocampus intro 3 sectors (anterior, medium and posterior). With the results obtained, the principal anamoto- radiologic aspects of the approach to the mesial aspect of the temporal lobe were analyzed, comparing them with results of previous reports. The proper knowledge of both morphologic and topographic anatomy of the mesial aspect of the temporal lobe is crucial for both interpreting radiologic studies and a correct surgical approach for surgical treatment of epilepsy.
Campero, A.; Tróccoli, G.; Martins, C.; Fernandez-Miranda, J. C.; Yasuda, A. & Rhoton, A. L. Jr. Microsurgical approaches to the medial temporal region: an anatomical study. Neurosurgery, 59(4 Suppl. 2):ONS279-307, 2006.
Choi, C.; Rubino, P. A.; Fernandez-Miranda, J. C.; Abe, H. & Rhoton, A. L. Jr. Meyer's loop and the optic radiations in the transsylvian approach to the mediobasal temporal lobe. Neurosurgery, 59(4 Suppl. 2):ONS228-35, 2006.
Duvernoy, H. M.; Cattin, F. & Risold, P. Y. The Human Hippocampus: Functional Anatomy, Vascularización, and Serial Sections with MRI. 3ª ed. Heidelberg, Springer, 2005.
Fernández-Miranda, J. C.; de Oliveira, E.; Rubino, P. A.; Wen, H. T. & Rhoton, A. L. Jr. Microvascular anatomy of the medial temporal region: part 1: its application to arteriovenous mal formation surgery. Neurosurgery, 67(3 Suppl. Operative):ons237-76, 2010.
Figueiredo, E. G.; Deshmukh, P.; Nakaji, P.; Crusius, M. U.; Teixeira, M. J.; Spetzler, R. F. & Preul, M. C. Anterior selective amygdalohippocampectomy: technical description and microsurgical anatomy. Neurosurgery, 66(3 Suppl. Operative):45-53, 2010.
Kucukyuruk, B.; Richardson, R. M.; Wen, H. T.; Fernandez-Miranda, J. C. & Rhoton, A. L. Jr. Microsurgical anatomy of the temporal lobe and its implications on temporal lobe epilepsy surgery. Epilepsy Res. Treat., 2012:769825, 2012.
Martínez, F.; Soria Vargas, V. R.; Sgarbi, N.; Laza, S. & Prinzo, H. Bases anatómicas de la hemisferotomía peri insular. Rev. Med. Urug., 20(3):208-14, 2004.
Peuskens, D.; van Loon, J.; Van Calenbergh, F.; van den Bergh, R.; Goffin, J. & Plets, C. Anatomy of the anterior temporal lobe and the frontotemporal region demonstrated by fiber dissection. Neurosurgery, 55(5):1174- 84, 2004.
Rhoton, A. L. Jr. The Cerebrum. Anatomy. Neurosurgery, 61(1 Suppl.):37-118, 2007.Ribas, G. C. The cerebral sulci and gyri. Neurosurg. Focus, 28(2):E2, 2010.
Spencer, D. D.; Spencer, S. S.; Mattson, R. H.; Williamson, P. D. & Novelly, R. A. Access to the posterior medial temporal lobe structures in the surgical treatment of temporal lobe epilepsy. Neurosurgery, 15(5):667-71, 1984.
Tubbs, R. S.; Miller, J. H.; Cohen-Gadol, A. A. & Spencer, D. D. Intraoperative anatomic landmarks for resection of the amygdala during medial temporal lobe surgery. Neurosurgery, 66(5):974-7, 2010.
Umeoka, S.; Terada, K.; Baba, K.; Usui, K.; Matsuda, K.; Tottori, T.; Usui, N.; Nakamura, F.; Inoue, Y.; Fujiwara, T. & Mihara, T. Neural connection between bilateral basal temporal regions: cortico-cortical evoked potential analysis in patients with temporal lobe epilepsy. Neurosrugery, 64(5):847-55, 2009.
Wen, H. T.; Rhoton, A. L. Jr.; de Oliveira, E.; Cardoso, A. C.; Tedeschi, H.; Baccanelli, M. & Marino, R. Jr. Microsurgical anatomy of the temporal lobe: part 1: mesial temporal lobe anatomy and its vascular relationships as applied to amygdalohippocampectomy. Neurosurgery, 45(3):549-91, 1999.
Wen, H. T.; Rhoton, A. L. Jr. & Marino, R. Jr. Anatomical landmarks for hemispherotomy and their clinical application. J. Neurosurg., 101(5):747-55, 2004.