IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Mesial temporal sclerosis and pineal cyst

Case contributed by Trent Orton
Diagnosis certain

Presentation

Seizures

Patient Data

Age: 20 years
Gender: Female

The left hippocampus is small and of high T2 signal. Incidental pineal cyst noted. 

Case Discussion

The patient went on to have an amygdalohippocampectomy. 

Histology

Microscopic Description:

Sections of the mesial block confirm a mild to moderate loss of neurons within CA1 of hippocampus. Although this is sufficient to permit a diagnosis of mesial temporal sclerosis, the changes are relatively mild. There are no other major features of cortical dysplasia or cerebral dysgenesis in the mesial structures. There is no evidence of neoplasia, vascular malformation, or a previous cranial cerebral trauma. The sections of the remainder of the lateral block show focal cerebral micro-dysgenesis with a localized aggregate of neurocytic-type cells. There is no significant cortical dysplasia in the material examined. There is retraction of perivascular white matter.

Final diagnosis: 

Mesial temporal sclerosis

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.