Neurology Medical News about temporal lobe resections;visual field deficits;diffusion tensor tractography

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Defining Meyer's loop–temporal lobe resections, visual field deficits and diffusion tensor tractography
Brain, 06/01/09

Yogarajah M et al. – Findings show considerable variation in the anterior extent of Meyer's loop. Thus, diffusion tensor tractography of optic radiation is a potentially useful method to assess an individual pt's risk of postoperative visual field deficits (VFDs) after anterior temporal lobe resection.

Methods

Use of seed voxels antero-lateral to lateral geniculate nucleus for diffusion tensor tractography as an advanced magnetic resonance imaging technique to enable white matter parcellation
Evaluation of 20 controls and 21 postoperative pts
Assessment with Goldmann perimetry of visual fields >3 mo after surgery
Measurement of distance from tip of Meyer's loop to temporal pole and horn
Measurement of size of temporal lobe resection by postoperative T1-weighted images
Quantification of VFDs

Results

VFDs in 9 pts, ranging from 22% to 87% of contralateral superior quadrant
Range of distance from tip of Meyer's loop to temporal pole: 24–43 mm (mean 34 mm) for pts vs 24–47 mm (mean 35 mm) for controls
Pt range of distance from tip of Meyer's loop to temporal horn: –15 to +9 mm (mean 0 mm) vs –11 to +9 mm (mean 0 mm) for controls
Both quantitative and qualitative results agreed with recent dissections of cadaveric brains, and analysis of postoperative VFDs and resection volumes
On linear regression analysis, both distance from tip of Meyer's loop to temporal pole and resection size were significant predictors of postoperative VFDs

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