By Gábor Szikla (auth.), F. John Gillingham, Jan Gybels, Edward Hitchcock, Gian Franco Rossi, Gábor Szikla (eds.)
Read or Download Advances in Stereotactic and Functional Neurosurgery 4: Proceedings of the 4th Meeting of the European Society for Stereotactic and Functional Neurosurgery, Paris 1979 PDF
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Additional info for Advances in Stereotactic and Functional Neurosurgery 4: Proceedings of the 4th Meeting of the European Society for Stereotactic and Functional Neurosurgery, Paris 1979
Szikla: In our opinion the remarkably smooth postoperative course might be related to several facts, namely that the pial membrane on the inner aspect of the temporal lobe is spared, thus closing the cavity of the removal, also after careful haemostasis, the cavity is filled with physiological saline solution and the dura mater hermetically sutured and sealed with an acrylic glue. C. Postoperative Controls This is an essential stage of the methodology. A first control is a photograph of the operation field (Fig.
6, A). In this case, this will be performed in 3 stages firstly superficial subpial excision of the suprasylvian Rolandic operculum together with the posterior third of the third frontal gyrus and the posterior three quarters of the superior temporal gyrus. Secondly superficial removal of a part of T 1, T 2, T 3 and finally, total lobectomy involving part of T 2, T 3, T 4 parahippocampal gyrus, uncus, amygdaloid nucleus and Ammon's horn. The posterior part of the latter will be removed intraventricularly with a curet so as to avoid complete destruction of the optic radiation winding around the temporal horn.
1 Sub- and transpial excision, 2 external excision, 3 total lobectomy: the brain stem and the tentorium cerebelli are visible. C. and D. Postoperative angiographic control: preoperative angiogram; postoperative angiogram performed in the same stereoctaxic projections. All important vessels are patent. -). E. Visual field of patient B: superior quadranopsia LG B. G. 1-6 _ 78 tJ1 i<-' ii> N Vl o p.. ::s I\> S- I\> ii> ::;. , ':-< o Application of Stereotactic Concepts to the Surgery of Epilepsy 51 Precise knowledge of the position of the ventricle allows the limitation of the extent of cortical removal posteriorly so as to spare as much as possible the optic radiation while removing Ammon's horn (5 mm behind electrode B).