Amygdalae Originated Tumors: A Formidable Surgical Entity, Microsurgical Technique to Save Function and Cure Epilepsy Located In Amygdal Region: A Formidable Surgical Strategy

Abstract

Background: Mesial temporal structures are notorious causes of epilepsy and although they have placed in strategic anatomical location they have been removed ending to epilepsy control and even cure. Amygdala well known element in limbic system has documented role in epileptogenesis located across the temporal horn just above the hippocampus and despite its famous neighbor has no clear and anatomically reliable boundary to its nearby indispensable neural structure like internal capsul basal ganglia and optic pathway. Its critical location make its removal very perilous and limited action.

Materials and Methods: Among the mesial temporal surgeries (113 cases) during 2005-2013 46 cases for MTS and 67 cases temporal lobe  tumors involving mesial structurs 4 cases can be considered primary amygdal tumors and one cases due to autohippocampectomy by temporal horn epidermoid which has made amygdal region the only culprit of epilepsy ethiology has been selected.

Results: In this regards we discuss fully surgical strategy and approach to this very rare lesion and especially crucial role of neuronavigation in reaching this deepest epileptogenic focus in human brain. And anatomical relationship and how the epilepsy surgeon should care about them will demonstrated

Conclusion: although primary amygdal tumors are rare they are one of most challenging neurosurgical task and its safe treatments demand careful and well judgmental surgical decision making and practice. Profound Knowledge of anatomy mastering microsurgical skill and use of modern neuronavigation tools will help the surgeon end up with beautiful surgery, saving important neural structure and cured and well saved patient.