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Pathological grading system for hippocampal sclerosis: correlation with magnetic resonance imaging-based volume measurements of the hippocampus

1996; Elsevier BV; Volume: 9; Issue: 1 Linguagem: Inglês

10.1016/0896-6974(95)00060-7

1873-6408

Craig Watson, Surl L. Nielsen, Cully A. Cobb, Robert Burgerman, Bill Williamson,

Advanced Neuroimaging Techniques and Applications

We studied 20 consecutive patients with medically intractable temporal lobe epilepsy (TLE) using volumetric magnetic resonance imaging (MRI) measurements of the hippocampus. We calculate a “preoperative hippocampal ratio” to determine the degree of hippocampal atrophy on the epileptogenic side as compared with that on the nonepileptogenic or normal side. We then correlated the degree of hippocampal atrophy with the severity of hippocampal sclerosis as determined by a practical, semiquantitative grading system adapted from the schema proposed by Wyler et al. (6). The study confirmed the usefulness of our six-tiered grading system in detecting and characterizing the severity of hippocampal sclerosis. Eighteen of our patients had identifiable hippocampal sclerosis, ranging from minimal (grade I) to severe (grade V). The degree of hippocampal atrophy as measured with preoperative volumetric MRI correlated well with the severity of hippocampal sclerosis as determined by the pathological grading system. These two techniques should aid in the diagnosis, treatment, and research assessment of patients with intractable TLE.