Assuntos
Malformações do Desenvolvimento Cortical , Giro Para-Hipocampal , Humanos , Malformações do Desenvolvimento Cortical/fisiopatologia , Malformações do Desenvolvimento Cortical/diagnóstico por imagem , Giro Para-Hipocampal/diagnóstico por imagem , Giro Para-Hipocampal/fisiopatologia , Eletroencefalografia , Masculino , Feminino , Imageamento por Ressonância Magnética , Convulsões/fisiopatologiaRESUMO
The medial temporal lobe (MTL) is a nidus for neurodegenerative pathologies and therefore an important region in which to study polypathology. We investigated associations between neurodegenerative pathologies and the thickness of different MTL subregions measured using high-resolution post-mortem MRI. Tau, TAR DNA-binding protein 43 (TDP-43), amyloid-ß and α-synuclein pathology were rated on a scale of 0 (absent)-3 (severe) in the hippocampus and entorhinal cortex (ERC) of 58 individuals with and without neurodegenerative diseases (median age 75.0 years, 60.3% male). Thickness measurements in ERC, Brodmann Area (BA) 35 and 36, parahippocampal cortex, subiculum, cornu ammonis (CA)1 and the stratum radiatum lacunosum moleculare (SRLM) were derived from 0.2 × 0.2 × 0.2 mm3 post-mortem MRI scans of excised MTL specimens from the contralateral hemisphere using a semi-automated approach. Spearman's rank correlations were performed between neurodegenerative pathologies and thickness, correcting for age, sex and hemisphere, including all four proteinopathies in the model. We found significant associations of (1) TDP-43 with thickness in all subregions (r = - 0.27 to r = - 0.46), and (2) tau with BA35 (r = - 0.31) and SRLM thickness (r = - 0.33). In amyloid-ß and TDP-43 negative cases, we found strong significant associations of tau with ERC (r = - 0.40), BA35 (r = - 0.55), subiculum (r = - 0.42) and CA1 thickness (r = - 0.47). This unique dataset shows widespread MTL atrophy in relation to TDP-43 pathology and atrophy in regions affected early in Braak stageing and tau pathology. Moreover, the strong association of tau with thickness in early Braak regions in the absence of amyloid-ß suggests a role of Primary Age-Related Tauopathy in neurodegeneration.
Assuntos
Córtex Entorrinal/diagnóstico por imagem , Hipocampo/diagnóstico por imagem , Doenças Neurodegenerativas/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/metabolismo , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides/metabolismo , Espessura Cortical do Cérebro , Região CA1 Hipocampal/diagnóstico por imagem , Região CA1 Hipocampal/metabolismo , Região CA1 Hipocampal/patologia , Estudos de Casos e Controles , Proteínas de Ligação a DNA/metabolismo , Córtex Entorrinal/metabolismo , Córtex Entorrinal/patologia , Feminino , Degeneração Lobar Frontotemporal/diagnóstico por imagem , Degeneração Lobar Frontotemporal/metabolismo , Degeneração Lobar Frontotemporal/patologia , Hipocampo/metabolismo , Hipocampo/patologia , Humanos , Doença por Corpos de Lewy/diagnóstico por imagem , Doença por Corpos de Lewy/metabolismo , Doença por Corpos de Lewy/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/metabolismo , Doenças Neurodegenerativas/patologia , Emaranhados Neurofibrilares/patologia , Giro Para-Hipocampal/diagnóstico por imagem , Giro Para-Hipocampal/metabolismo , Giro Para-Hipocampal/patologia , Doença de Pick/diagnóstico por imagem , Doença de Pick/metabolismo , Doença de Pick/patologia , Placa Amiloide/patologia , Paralisia Supranuclear Progressiva/diagnóstico por imagem , Paralisia Supranuclear Progressiva/metabolismo , Paralisia Supranuclear Progressiva/patologia , Lobo Temporal/metabolismo , Lobo Temporal/patologia , alfa-Sinucleína/metabolismo , Proteínas tau/metabolismoRESUMO
BACKGROUND: The parahippocampal gyrus is understood to have a role in high cognitive functions including memory encoding and retrieval and visuospatial processing. A detailed understanding of the exact location and nature of associated white tracts could significantly improve postoperative morbidity related to declining capacity. Through diffusion tensor imaging-based fiber tracking validated by gross anatomic dissection as ground truth, we have characterized these connections based on relationships to other well-known structures. METHODS: Diffusion imaging from the Human Connectome Project for 10 healthy adult controls was used for tractography analysis. We evaluated the parahippocampal gyrus as a whole based on connectivity with other regions. All parahippocampal gyrus tracts were mapped in both hemispheres, and a lateralization index was calculated with resultant tract volumes. RESULTS: We identified 2 connections of the parahippocampal gyrus: inferior longitudinal fasciculus and cingulum. Lateralization of the cingulum was detected (P < 0.05). CONCLUSIONS: The parahippocampal gyrus is an important center for memory processing. Subtle differences in executive functioning following surgery for limbic tumors may be better understood in the context of the fiber-bundle anatomy highlighted by this study.
Assuntos
Rede Nervosa/anatomia & histologia , Rede Nervosa/diagnóstico por imagem , Giro Para-Hipocampal/anatomia & histologia , Giro Para-Hipocampal/diagnóstico por imagem , Substância Branca/anatomia & histologia , Substância Branca/diagnóstico por imagem , Adulto , Conectoma/métodos , Imagem de Tensor de Difusão/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Diagnosis of Alzheimer's disease (AD) is often difficult because of distinct and subjective clinical features, especially in the early stage. FOXO3a protein present in the cognitive centre of brain in inferior temporal region and parahippocampus. FOXO3a can be a potential novel target against AD. AD, Mild Cognitive impairment (MCI) and Geriatric Control (GC) were recruited after diagnosis by clinical assessment, MRI, TauPET and FDG-PET. We have quantified serum FOXO3a by surface plasmon resonance (SPR) and compare with TauPET between of AD, MCI patients and GC. Serum FOXO3A was significantly lower in AD (1.42 ± 0.09 ng/µl) compare to MCI (1.61 ± 0.14 ng/µl) and GC (1.89 ± 0.07 ng/µl). However, the Tau was higher in AD both in serum and also in PET scan. Serum pTau was significantly over-expressed in AD (0.176 ± 0.03 ng/µl), compare to other groups; MCI (0.16 ± 0.014 ng/µl) and GC (0.15 ± 0.024 ng/µl). Serum FOXO3A could significantly differentiate AD vs MCI, MCI vs GC and AD vs GC. However, Tau protein could only differentiate AD vs GC but not MCI vs GC. Serum FOXO3A may serve as novel blood marker for early detection for AD and target for therapeutic intervention.
Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Proteína Forkhead Box O3/sangue , Idoso , Doença de Alzheimer/sangue , Doença de Alzheimer/diagnóstico , Biomarcadores/sangue , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/metabolismo , Diagnóstico Precoce , Feminino , Perfilação da Expressão Gênica , Avaliação Geriátrica/métodos , Humanos , Masculino , Giro Para-Hipocampal/diagnóstico por imagem , Giro Para-Hipocampal/metabolismo , Tomografia por Emissão de Pósitrons/métodos , Ressonância de Plasmônio de Superfície/métodos , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/metabolismo , Proteínas tau/sangueRESUMO
BACKGROUND: Patients with a lesion within the amygdala and uncus may develop temporal lobe epilepsy despite having functional mesial structures. Resection of functional hippocampus and surrounding structures may lead to unacceptable iatrogenic deficits. To our knowledge, there is limited descriptions of surgical techniques for selectively resecting the amygdala and uncus lesions while preserving the hippocampus in patients with language-dominant temporal lobe pathology. METHODS: Thirteen patients with language-dominant temporal lobe epilepsy related to amygdala-centric lesions were identified. Patients with sclerosis of the mesial structures or evidence of pathology outside of the amygdala-uncus region were excluded. Neuropsychological evaluation confirmed normal function of the mesial structures ipsilateral to the lesion. All patients were worked up with video-EEG, high-resolution brain MRI, neuro-psychology evaluation, and either Wada or functional MRI testing. RESULTS: All patients underwent selective resection of the lesion including amygdala and uncus with preservation of the hippocampus via a transcortical inferior temporal gyrus approach to the mesial temporal lobe. Pathology was compatible with glioneuronal tumors. Post-operative MRI demonstrated complete resection in all patients. Eight of the thirteen patients underwent post-operative neuropsychology evaluations and did not demonstrate any significant decline in tasks of delayed verbal recall or visual memory based on the Rey Auditory Verbal Learning Test (RAVLT). One patient showed a slight decrease in confrontation naming using the Boston Naming Test (BNT). Seizure freedom (Engel class I) was achieved in 12 of 13 patients. CONCLUSION: Selective transcortical amygdala and uncus resection with hippocampus preservation may be a reasonable way to achieve seizure control while sparing functional mesial structures.
Assuntos
Tonsila do Cerebelo/cirurgia , Neoplasias Encefálicas/cirurgia , Epilepsia do Lobo Temporal/cirurgia , Ganglioglioma/cirurgia , Giro Para-Hipocampal/cirurgia , Adolescente , Adulto , Tonsila do Cerebelo/diagnóstico por imagem , Neoplasias Encefálicas/diagnóstico por imagem , Eletroencefalografia , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/etiologia , Feminino , Ganglioglioma/diagnóstico por imagem , Hipocampo/cirurgia , Humanos , Idioma , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Giro Para-Hipocampal/diagnóstico por imagem , Complicações Pós-Operatórias/psicologia , Esclerose , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/cirurgia , Resultado do Tratamento , Adulto JovemRESUMO
PURPOSE: Type IIB focal cortical dysplasia (FCD) is an important cause of drug-resistant epilepsy. However, balloon cells located in the medial temporal lobe have been seldom reported. We aimed to discuss the clinical and pathological features of Type IIB FCD with balloon cells in the medial temporal lobe (MTLE-FCDIIB) and the differential diagnosis with other types of mesial temporal lobe epilepsy. METHODS: Three MTLE-FCDIIB cases were enrolled from Peking Union Medical College Hospital. Clinical and neuroimaging data were analyzed and histology features observed on hematoxylin-eosin (H&E) staining and immunochemical staining, including vimentin, nestin, S-100, CD34, neuronal nuclei antigen (Neun), glial fibrillary acidic protein (GFAP), neurofilament heavy chain (SMI32), were discussed. RESULTS: All cases involved drug-resistant epilepsy patients with childhood onset. The semiology of the epileptic seizure was a highly frequent partial seizure with or without generalized tonic-clonic seizures. Magnetic resonance imaging showed hyper-intensity in the medial temporal lobe without atrophy, different from mesial temporal sclerosis. Histological examination indicated the presence of balloon cells in the white matter of the para-hippocampal gyrus, subiculum, and cornu ammonis with cortical disorganization, and SMI32 positive dysmorphic neurons in the gray matter. Balloon cells were immunohistochemically stained with vimentin and nestin. Granular cell dispersion and pyramidal cell loss were not found. CONCLUSIONS: The presence of balloon cells in the medial temporal lobe is observed in a rare subgroup of FCD, named MTLE-FCDIIB. It has distinct clinical manifestations, neuroimaging features, pathological changes, and prognosis, which should be differentiated from mesial temporal lobe sclerosis and mesial temporal lobe tumors. Our findings enable more accurate diagnosis of mesial temporal lobe epilepsy.
Assuntos
Epilepsia do Lobo Temporal/patologia , Epilepsia/patologia , Hipocampo/patologia , Malformações do Desenvolvimento Cortical do Grupo I/patologia , Giro Para-Hipocampal/patologia , Adolescente , Adulto , Antígenos Nucleares/metabolismo , Epilepsia/diagnóstico por imagem , Epilepsia/metabolismo , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/metabolismo , Feminino , Proteína Glial Fibrilar Ácida/metabolismo , Hipocampo/diagnóstico por imagem , Hipocampo/metabolismo , Humanos , Imageamento por Ressonância Magnética , Malformações do Desenvolvimento Cortical do Grupo I/diagnóstico por imagem , Malformações do Desenvolvimento Cortical do Grupo I/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Nestina/metabolismo , Neuroimagem , Neurônios/metabolismo , Neurônios/patologia , Giro Para-Hipocampal/diagnóstico por imagem , Giro Para-Hipocampal/metabolismo , Tomografia Computadorizada por Raios X , Vimentina/metabolismoRESUMO
Pre-clinical research in rodents provides evidence that the central nervous system (CNS) has functional lymphatic vessels. In-vivo observations in humans, however, are not demonstrated. We here show data on CNS lymphatic drainage to cervical lymph nodes in-vivo by magnetic resonance imaging (MRI) enhanced with an intrathecal contrast agent as a cerebrospinal fluid (CSF) tracer. Standardized MRI of the intracranial compartment and the neck were acquired before and up to 24-48 hours following intrathecal contrast agent administration in 19 individuals. Contrast enhancement was radiologically confirmed by signal changes in CSF nearby inferior frontal gyrus, brain parenchyma of inferior frontal gyrus, parahippocampal gyrus, thalamus and pons, and parenchyma of cervical lymph node, and with sagittal sinus and neck muscle serving as reference tissue for cranial and neck MRI acquisitions, respectively. Time series of changes in signal intensity shows that contrast enhancement within CSF precedes glymphatic enhancement and peaks at 4-6 hours following intrathecal injection. Cervical lymph node enhancement coincides in time with peak glymphatic enhancement, with peak after 24 hours. Our findings provide in-vivo evidence of CSF tracer drainage to cervical lymph nodes in humans. The time course of lymph node enhancement coincided with brain glymphatic enhancement rather than with CSF enhancement.
Assuntos
Cistos Aracnóideos/diagnóstico por imagem , Sistema Glinfático/diagnóstico por imagem , Hidrocefalia/diagnóstico por imagem , Hipertensão Intracraniana/diagnóstico por imagem , Hipotensão Intracraniana/diagnóstico por imagem , Sistema Linfático/diagnóstico por imagem , Adulto , Idoso , Cistos Aracnóideos/líquido cefalorraquidiano , Cistos Aracnóideos/fisiopatologia , Estudos de Coortes , Meios de Contraste/administração & dosagem , Feminino , Sistema Glinfático/metabolismo , Sistema Glinfático/fisiopatologia , Humanos , Hidrocefalia/líquido cefalorraquidiano , Hidrocefalia/fisiopatologia , Injeções Espinhais , Hipertensão Intracraniana/líquido cefalorraquidiano , Hipertensão Intracraniana/fisiopatologia , Hipotensão Intracraniana/líquido cefalorraquidiano , Hipotensão Intracraniana/fisiopatologia , Linfonodos/diagnóstico por imagem , Linfonodos/metabolismo , Linfonodos/fisiopatologia , Sistema Linfático/metabolismo , Sistema Linfático/fisiopatologia , Vasos Linfáticos/diagnóstico por imagem , Vasos Linfáticos/metabolismo , Vasos Linfáticos/fisiopatologia , Linfografia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Compostos Organometálicos/administração & dosagem , Giro Para-Hipocampal/diagnóstico por imagem , Giro Para-Hipocampal/metabolismo , Giro Para-Hipocampal/fisiopatologia , Tecido Parenquimatoso/diagnóstico por imagem , Tecido Parenquimatoso/metabolismo , Tecido Parenquimatoso/fisiopatologia , Ponte/diagnóstico por imagem , Ponte/metabolismo , Ponte/fisiopatologia , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/metabolismo , Córtex Pré-Frontal/fisiopatologia , Tálamo/diagnóstico por imagem , Tálamo/metabolismo , Tálamo/fisiopatologiaRESUMO
OBJECTIVES: Studies employing voxel-based morphometry (VBM) have reported inconsistent findings on the association of gray matter (GM) abnormalities with fibromyalgia. The aim of the present study is to identify the most prominent and replicable GM areas that involved in fibromyalgia. METHODS: A systematic search of the PubMed database from January 2000 to September 2015 was performed to identify eligible whole-brain VBM studies. Comprehensive meta-analyses to investigate regional GM abnormalities in fibromyalgia were conducted with the Seed-based d Mapping software package. RESULTS: Seven studies, reporting nine comparisons and including a grand total of 180 fibromyalgia patients and 126 healthy controls, were included in the meta-analyses. In fibromyalgia patients compared with healthy controls, regional GM decreases were consistently found in the bilateral anterior cingulate/paracingulate cortex/medial prefrontal cortex, the bilateral posterior cingulate/paracingulate cortex, the left parahippocampal gyrus/fusiform cortex, and the right parahippocampal gyrus/hippocampus. Regional GM increases were consistently found in the left cerebellum. Meta-regression demonstrated that age was correlated with GM anomalies in fibromyalgia patients. CONCLUSIONS: The current meta-analysis identified a characteristic pattern of GM alterations within the medial pain system, default mode network, and cerebro-cerebellar circuits, which further supports the concept that fibromyalgia is a symptom complex involving brain areas beyond those implicated in chronic pain.
Assuntos
Encéfalo/diagnóstico por imagem , Fibromialgia/diagnóstico por imagem , Substância Cinzenta/diagnóstico por imagem , Fatores Etários , Encéfalo/patologia , Estudos de Casos e Controles , Fibromialgia/patologia , Substância Cinzenta/patologia , Giro do Cíngulo/diagnóstico por imagem , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Humanos , Tamanho do Órgão , Giro Para-Hipocampal/diagnóstico por imagem , Giro Para-Hipocampal/patologia , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/patologia , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologiaRESUMO
BACKGROUND: Little is known about connectivity within the default mode network (DMN) in heroin-dependent individuals (HDIs). In the current study, diffusion-tensor imaging (DTI) and resting-state functional MRI (rs-fMRI) were combined to investigate both structural and functional connectivity within the DMN in HDIs. METHODS: Fourteen HDIs and 14 controls participated in the study. Structural (path length, tracts count, (fractional anisotropy) FA and (mean diffusivity) MD derived from DTI tractography)and functional (temporal correlation coefficient derived from rs-fMRI) DMN connectivity changes were examined in HDIs. Pearson correlation analysis was performed to compare the structural/functional indices and duration of heroin use/Iowa gambling task(IGT) performance in HDIs. RESULTS: HDIs had lower FA and higher MD in the tract connecting the posterior cingulate cortex/precuneus (PCC/PCUN) to right parahippocampal gyrus (PHG), compared to the controls. HDIs also had decreased FA and track count in the tract connecting the PCC/PCUN and medial prefrontal cortex (MPFC), as well as decreased functional connectivity between the PCC/PCUN and bilateral PHG and MPFC, compared to controls. FA values for the tract connecting PCC/PCUN to the right PHG and connecting PCC/PCUN to the MPFC were negatively correlated to the duration of heroin use. The temporal correlation coefficients between the PCC/PCUN and the MPFC, and the FA values for the tract connecting the PCC/PCUN to the MPFC were positively correlated to IGT performance in HDIs. CONCLUSIONS: Structural and functional connectivity within the DMN are both disturbed in HDIs. This disturbance progresses as duration of heroin use increases and is related to deficits in decision making in HDIs.
Assuntos
Dependência de Heroína/patologia , Heroína/efeitos adversos , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Encéfalo/fisiologia , Mapeamento Encefálico , Estudos de Casos e Controles , Imagem de Tensor de Difusão , Giro do Cíngulo/diagnóstico por imagem , Giro do Cíngulo/patologia , Giro do Cíngulo/fisiologia , Heroína/urina , Dependência de Heroína/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Giro Para-Hipocampal/diagnóstico por imagem , Giro Para-Hipocampal/patologia , Giro Para-Hipocampal/fisiologia , RadiografiaRESUMO
BACKGROUND: Positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG) shows widespread hypometabolism even in temporal lobe epilepsy (TLE) patients with mesial temporal foci. (18)F-trans-4-fluoro-N-2-[4-(2-methoxyphenyl) piperazin-1-yl]ethyl-N-(2-pyridyl)cyclohexane carboxamide ((18)F-FCWAY) PET may show more specific 5-HT(1A)-receptor binding reduction in seizure initiation than in propagation regions. (18)FCWAY PET might be valuable for detecting epileptic foci, and distinguishing mesial from lateral temporal foci in MRI-negative patients with TLE. METHODS: We performed (18)F-FCWAY-PET and (18)F-FDG-PET in 12 MRI-negative TLE patients who had had either surgery or subdural electrode recording, and 15 healthy volunteers. After partial volume correction for brain atrophy, free fraction-corrected volume of distribution (V/f1) measurement and asymmetry indices (AIs) were computed. We compared (18)F-FCWAY-PET and (18)F-FDG-PET results with scalp video electroencephalography (EEG), invasive EEG, and surgical outcome. RESULTS: Mean (18)F-FCWAY V/f1, compared with normal controls, was decreased significantly in fusiform gyrus, hippocampus, and parahippocampus ipsilateral to epileptic foci, and AIs were significantly greater in hippocampus, parahippocampus, fusiform gyrus, amygdala, and inferior temporal regions. Eleven patients had clearly lateralized epileptogenic zones. Nine had congruent, and two nonlateralized, (18)F-FCWAY PET. One patient with bitemporal seizure onset had nonlateralized (18)F-FCWAY-PET. (18)F-FDG-PET showed congruent hypometabolism in 7 of 11 EEG-lateralized patients, bilateral hypometabolic regions in one, contralateral hypometabolism in one, as well as lateralized hypometabolism in the patient with bitemporal subdural seizure onset. Patients with mesial temporal foci tended to have lower superior and midtemporal (18)F-FCWAY V/f1 binding AI than those with lateral or diffuse foci. CONCLUSION: (18)F-FCWAY-PET can detect reduced binding in patients with normal MRI, and may be more accurate than (18)F-FDG-PET.
Assuntos
Glicemia/metabolismo , Cicloexanos , Epilepsia do Lobo Temporal/diagnóstico por imagem , Fluordesoxiglucose F18 , Imageamento por Ressonância Magnética , Piperazinas , Tomografia por Emissão de Pósitrons/métodos , Lobo Temporal/diagnóstico por imagem , Adolescente , Adulto , Tonsila do Cerebelo/diagnóstico por imagem , Lobectomia Temporal Anterior , Encéfalo/diagnóstico por imagem , Dominância Cerebral/fisiologia , Eletroencefalografia , Epilepsia do Lobo Temporal/cirurgia , Feminino , Lobo Frontal/diagnóstico por imagem , Hipocampo/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Giro Para-Hipocampal/diagnóstico por imagem , Receptor 5-HT1A de Serotonina/metabolismo , Lobo Temporal/cirurgia , Gravação em Vídeo , Adulto JovemRESUMO
Choroid plexus papilloma (CPP) arising in the temporal horn is rare in adult population, and to the best of our knowledge, there has been no report of such a case with temporal lobe epilepsy (TLE). The authors describe a unique case of a 27-year-old woman who was diagnosed as TLE and was found to have a CPP in the temporal horn. Choroid plexus papilloma of the temporal horn, even though rare, can be found in adult population and be causally related to temporal lobe epilepsy.
Assuntos
Epilepsia do Lobo Temporal/etiologia , Epilepsia do Lobo Temporal/patologia , Ventrículos Laterais/patologia , Papiloma do Plexo Corióideo/complicações , Papiloma do Plexo Corióideo/patologia , Lobo Temporal/patologia , Adulto , Epilepsia do Lobo Temporal/fisiopatologia , Células Epiteliais/patologia , Feminino , Humanos , Ventrículos Laterais/diagnóstico por imagem , Ventrículos Laterais/fisiopatologia , Imageamento por Ressonância Magnética , Procedimentos Neurocirúrgicos , Papiloma do Plexo Corióideo/diagnóstico por imagem , Giro Para-Hipocampal/diagnóstico por imagem , Giro Para-Hipocampal/patologia , Giro Para-Hipocampal/fisiopatologia , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/fisiopatologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
This report describes a rare case of a distal right anterior choroidal artery aneurysm which developed a right intracerebral haematoma and intraventricular haemorrhage and was treated by surgical exploration and clipping with the aid of a limited subpial resection of the uncus and ambient gyrus. The technique of limited subpial uncal resection allows the surgeon to follow the anterior choroidal artery without much difficulty, achieves proximal control early and aids in the eventual clipping procedure.