Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A case of hippocampal sclerosis diagnosed as cortical dysplasia due to preoperative brain MRI finding

수술 전 뇌 자기공명 영상에서 겉질 형성이상증 소견 보였으나 수술 후 병리학적으로 확인된 해마경화증 1례

  • Lee, Jun Seok (Department of Pediatrics, Severance Children's Hospital Yonsei University College of Medicine) ;
  • Kim, Kyo Ryung (Department of Pediatrics, Severance Children's Hospital Yonsei University College of Medicine) ;
  • Kim, Jeong Tae (Department of Pediatrics, Severance Children's Hospital Yonsei University College of Medicine) ;
  • Choi, Min Jung (Department of Pediatrics, Severance Children's Hospital Yonsei University College of Medicine) ;
  • Lee, Young Mock (Department of Pediatrics, Severance Children's Hospital Yonsei University College of Medicine) ;
  • Kim, Heung Dong (Department of Pediatrics, Severance Children's Hospital Yonsei University College of Medicine) ;
  • Lee, Joon Soo (Department of Pediatrics, Severance Children's Hospital Yonsei University College of Medicine) ;
  • Kim, Dong Seok (Department of Neurosurgery, Severance Children's Hospital Yonsei University College of Medicine) ;
  • Kim, Tae Seong (Department of Pathology, Severance Children's Hospital Yonsei University College of Medicine)
  • 이준석 (연세대학교 의과대학 소아과학교실) ;
  • 김교륭 (연세대학교 의과대학 소아과학교실) ;
  • 김정태 (연세대학교 의과대학 소아과학교실) ;
  • 최민정 (연세대학교 의과대학 소아과학교실) ;
  • 이영목 (연세대학교 의과대학 소아과학교실) ;
  • 김흥동 (연세대학교 의과대학 소아과학교실) ;
  • 이준수 (연세대학교 의과대학 소아과학교실) ;
  • 김동석 (연세대학교 의과대학 신경외과학교실) ;
  • 김태승 (연세대학교 의과대학 병리과교실)
  • Received : 2009.06.10
  • Accepted : 2009.10.26
  • Published : 2010.01.15
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Abstract

Hippocampal sclerosis (HS) is one of the most common features of intractable temporal lobe epilepsy. Generally it can be identified through brain magnetic resonance imaging (MRI) with high degree of sensitivity and specificity. Typical brain MRI findings of HS are hippocampal atrophy with hyperintense signal confined to the lesion. On the other hand cortical dysplasia exhibits blurring of the gray-white matter junction and abnormal white matter signal intensity. We present a case where preoperative brain MRI strongly suggested the presence of diffuse cortical dysplasia in the left temporal lobe but postoperative pathology revealed the temporal lesion to be unremarkable except for hippocampal sclerosis.

해마경화증은 난치성 측두엽간질의 가장 흔한 원인들 중 하나이다. 일반적으로 해마경화증은 뇌 자기공명영상에서 높은 민감도와 특이도로 규명될 수 있다. 이 병변의 뇌 자기공명영상 소견은 해마에 국한된 조영증가와 이와 연관된 위축된 해마 소견이라 할 수 있다. 반면에 국소성 겉질 형성이상증은 회백질-백질 경계부의 불분명함, 백질 부분의 이상 조영증강 소견을 보인다. 저자들은 수술적 치료 이전에 뇌 자기공명 영상에서 좌측 측두엽의 겉질 형성이상증의 소견을 보였으나, 수술 후 병리검사에서 해마경화증 외에 정상소견을 보였던 1례를 경험하였기에 보고하고자 한다.

Keywords

References

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