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Purpose: Antero-inferior temporal lobe meningoencephaloceles are a rare, but increasingly recognized cause of drug-resistant temporal lobe epilepsy (TLE). In order to evaluate whether these lesions are related to idiopathic intracranial hypertension (IIH), we analyzed clinical and MRI findings of a cohort of patients undergoing presurgical work-up. Methods: Seizure onset in the anterior temporal lobe was proven by EEG electrodes in 22 patients, and in 21 patients, anterior temporal lobectomy (mostly with sparing of the hippocampus) was performed. MRI signs of IIH (in particular empty sella) and the volumes of the ventricles and external CSF spaces were determined and related to the body mass index (BMI) and clinical outcome. Results: Six of seven obese (BMI > 30 kg/m) compared to four of 15 non-obese patients had partial empty or empty sella ( p = 0.007). Bilateral lesions were found in all obese and 11 patients. Seizure freedom (Engel class 1A) was achieved in 12 of 21 patients (5 obese compared to 7 non-obese patients). BMI was related to the volume of the external CSF spaces ( r = 0.467), and age at seizure onset was higher in obese patients. Conclusion: Roughly a third of patients with temporal lobe epilepsy due to antero-inferior meningoencephaloceles is obese and has MRI signs of idiopathic intracranial hypertension. [ABSTRACT FROM AUTHOR]

Malformations of the corpus callosum (CC) may occur in many different syndromes. Various forms have been observed. We report seven cases of malformation of the CC. Special attention is directed towards the development of the fornix and hippocampus as a hippocampal commissure is a prerequisite of normal hippocampal development. The clinical disability of the patients presented here differed significantly, which may in part be due to the different extent of this cerebral malformation. The relevance of the concomitant aplasia of the limbic system has not been addressed in detail previously in the literature. [ABSTRACT FROM AUTHOR]

Abstract: Probability mapping of connectivity is a powerful tool to determine the fibre structure of white matter in the brain. Probability maps are related to the degree of connectivity to a chosen seed area. In many applications, however, it is necessary to isolate a fibre bundle that connects two areas. A frequently suggested solution is to select curves, which pass only through two or more areas. This is very inefficient, especially for long-distance pathways and small areas. In this paper, a novel probability-based method is presented that is capable of extracting neuronal pathways defined by two seed points. A Monte Carlo simulation based tracking method, similar to the Probabilistic Index of Connectivity (PICo) approach, was extended to preserve the directional information of the main fibre bundles passing a voxel. By combining two of these extended visiting maps arising from different seed points, two independent parameters are determined for each voxel: the first quantifies the uncertainty that a voxel is connected to both seed points; the second represents the directional information and estimates the proportion of fibres running in the direction of the other seed point (connecting fibre) or face a third area (merging fibre). Both parameters are used to calculate the probability that a voxel is part of the bundle connecting both seed points. The performance and limitations of this DTI-based method are demonstrated using simulations as well as in vivo measurements. [Copyright &y& Elsevier]