MACROSCOPIC DESCRIPTION: 1. "Hippocampus": A segment of hippocampus with attached mesial temporal tissue - 25x11x7mm. Serially sliced and all submitted. 2. "Normal lateral neocortex": A wedge shaped portion of cerebral cortex and white matter - 30x20x10mm. Serially sliced and all submitted.
MICROSCOPIC DESCRIPTION: 1. Serial sections of hippocampus show almost complete loss of neurones from the CA1 sector of the hippocampal cortex. There is mild neuronal depletion in the CA3 and CA4 sectors. Neuronal numbers in CA2 are intact. The neuronal loss is accompanied by moderate reactive astrocytic gliosis. There is moderate loss of neurones from the dentate fasciculus with dispersion of residual neurones. The features are of hippocampal sclerosis - ILAE Type 2. There is no inflammation. No evidence of tumlur is seen. 2. The sections show temporal neocortex and white matter. There is moderate gliosis of the sub-pial molecular layer (Chaslin's sclerosis). Cortical lamination is intact. No features of malformation of cortical development are seen. Moderate numbers of neurones are noted in white matter. Myelination is normal. There is no inflammationm and no evidence of tumour is seen.
DIAGNOSIS:
1. Hippocampus: Hippocampal sclerosis - ILAE Type 2.
2. Lateral neocortex: Moderate Chaslin's sclerosis only.
Note: The first image with annotated hippocampal segments corresponds to a normal hippocampus from another patient for comparison.