Hippocampal sclerosis: Histopathology substrate and magnetic resonance imaging.
Hippocampal sclerosis: Histopathology substrate and magnetic resonance imaging.
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DOI：
10.1053/j.sult.2007.11.005
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发表时间：
2008-02-01
影响因子：
1.1
通讯作者：
De Felipe, Javier
中科院分区：
文献类型：
--
作者：
Bote, Ramon Palacios;Blazquez-Llorca, Lidia;De Felipe, Javier
海马硬化症一词最初用于描述萎缩和硬化的海马，其在组织学上表现为神经元丢失和神经胶质增生。这些改变主要位于齿状回门和CA1和CA3锥体细胞层，但所有海马区域均可显示不同程度的神经元细胞丢失。许多形态学和细胞化学的发现与内侧颞叶硬化有关，特别是在齿状回内。这些变化包括抑制性中间神经元的选择性丧失、轴突的异常发芽、神经递质受体的重组、第二信使系统的改变和颗粒细胞的过度兴奋。在其他颞叶结构中也发现海马外病变。频繁的海马外病变影响杏仁核，首先见于外侧基底复合体的神经元细胞丢失和神经胶质增生。手术切除这一致癫痫区域可以治愈或提供显着减少癫痫发作的频率在大多数人。当使用正确的MRI颞叶方案时，磁共振成像（MRI）在检测和定位内侧颞叶硬化方面具有高度敏感性。最重要的MRI表现，萎缩和异常T2信号，使我们能够检测到颞叶内侧硬化症的大多数情况下。继发性MRI检查有助于原发灶不明显和双侧海马异常的颞叶内侧硬化的诊断和定侧。先进的磁共振（MR）技术的发展，如功能性MR，扩散或磁化转移，将导致更好地了解这种病理，并将提高我们的诊断能力。
The term hippocampal sclerosis was originally used to describe a shrunken and hardened hippocampus, which histologically displayed neuronal loss and glial proliferation. These alterations are mainly located in the hilus of the dentate gyrus and in the CA1 and CA3 pyramidal cell layers but all hippocampal regions may show neuronal cell loss to varying degrees. A number of morphologic and cytochemical findings are associated with mesial temporal sclerosis, especially within the dentate gyrus. These changes include selective loss of inhibitory interneurons, abnormal sprouting of axons, reorganization of neural transmitter receptors, alterations in second messenger systems, and hyperexcitability of the granule cells. Extrahippocampal pathology is also found at other temporal lobe structures. Frequent extrahippocampal pathology affects the amygdala, first seen with neuronal cell loss and gliosis in the laterobasal complex. Surgical removal of this epileptogenic area can be curative or provide significant reduction in seizure frequency in the majority of individuals. Magnetic resonance imaging (MRI) is highly sensitive in detecting and locating mesial temporal sclerosis when a correct MRI temporal lobe protocol is used. The most important MRI findings, atrophy and abnormal T2 signal, allow us to detect mesial temporal sclerosis in the majority of the cases. Secondary MRI findings help in the diagnosis and lateralization of mesial temporal sclerosis in patients with subtle primary findings and in cases of bilateral hippocampal abnormalities. The development of advanced magnetic resonance (MR) techniques, such as functional MR, diffusion, or transference of magnetization, will lead to greater understanding of this pathology and will improve our diagnostic capacity.