Incidental Detection of Hippocampal Sclerosis on MR Images: Is It Significant?
Kevin R. Moore
,a,
Charles E. Swallowa and
Jay S. Tsurudaa
a From the Department of Radiology, Section of Neuroradiology, University of Utah School of Medicine (K.R.M., J.S.T., C.E.S.), and the Salt Lake Veterans Administration Medical Center, Salt Lake City, UT (K.R.M., J.S.T., C.E.S.).
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FIG 1. 19-year-old nonepileptic patient with hearing loss. T2-weighted FSE (4000/80/3) image shows normal hippocampi bilaterally (arrows). Incidentally noted is a right acoustic schwannoma.
FIG 2. Case 1: 29-year-old woman with new seizure onset 17 months after AVM hemorrhage. T2-weighted image (4000/80/3) obtained using the screening ear protocol 17 months after initial AVM hemorrhage shows unilateral right hippocampal sclerosis (arrow) with ipsilateral temporal lobe volume loss. No confirmatory high-resolution temporal lobe imaging was performed because the patient was not considered to be a surgical candidate.
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FIG 3. Case 2: 46-year-old woman with seizures.
A, T2-weighted image (4000/80/3) obtained using the screening ear protocol shows unilateral left hippocampal sclerosis (arrow) with volume loss, poor delineation of internal architecture, and T2 hyperintensity.
B and C, Subsequent dedicated high-resolution T1-weighted SPGR image (23/4, 45° flip angle) (B) and T2-weighted FSE image (4860/100/2) (C) confirm hippocampal sclerosis (arrows). There is no forniceal volume loss.
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