Bilateral Hippocampal Sclerosis
•Not infrequently, hippocampal sclerosis affects both hippocampi .
Due to this fact, visual analysis of
potential signal changes of the hippocampus must be done not only by
comparison with the contralateral hippocampus, but also with the ipsilateral
cortical grey matter of the temporal lobe.
Figure 23. Bilateral hippocampal sclerosis. Coronal
fast-SE T2W MRI in a patient with intractable temporal lobe epilepsy, who
demonstrates bilateral hippocampal sclerosis. Observe the symmetrical signal
intensity and volume of the hippocampi. However, their signal intensity is
clearly increased in comparison with the cortical grey matter of the temporal
lobe.
Figure 22. Unilateral hippocampal sclerosis. Coronal
fast-SE T2WI obtained in a patient with intractable temporal lobe epilepsy,
demonstrates high signal intensity and decreased volume of the right
hippocampus (left). Note also a slightly enlarged temporal horn. Compare these
findings with a normal hippocampus (right).
(Fig. 23)