title: Focal cortical dysplasia of Taylor's balloon cell type: a clinicopathological entity with characteristic neuroimaging and histopathological features, and favorable postsurgical outcome.
abstract: OBJECTIVE
  Focal cortical dysplasia of Taylor's balloon-cell type (FCD-BC) are a frequent cause of pharmacoresistant epilepsy in young patients. In order to characterize FCD-BC, we coupled MRI and histopathology, and analyzed the clinical outcome following epilepsy surgery.
  
  
  METHODS
  From an epilepsy data bank with 547 histological specimens, 17 FCD-BC were re-evaluated of which high resolution MRI was available. Five additional FCD-BC were prospectively identified by MRI. Histopathological and immunohistochemical features were related to MRI. Outcome following lesionectomy was analyzed as determined on routine examinations 3, 6 and 12 months following surgery.
  
  
  RESULTS
  All but one lesion were located outside the temporal lobe. A markedly hyperintense funnel-shaped subcortical zone tapering towards the lateral ventricle was the characteristic finding on FLAIR MRI. Histopathologically, the subcortical zone of the FCD-BC displayed hypomyelinated white matter with radially oriented balloon cells and gliosis. Dysplastic neurons were found in the adjacent, disorganized cortex. All patients with complete lesionectomy were seizure free one year following surgery.
  
  
  CONCLUSIONS
  Focal cortical dysplasias of Taylor's balloon-cell type (FCD-BC) have characteristic MRI and histopathological findings. MRI recognition is important, since outcome following resective surgery is favorable.
authors.affiliation: Department of Radiology/Neuroradiology, University of Bonn Medical Center, Bonn, Germany. urbach@uni-bonn.de
authors.forename: Horst
authors.initials: H
authors.lastname: Urbach
authors.forename: Björn
authors.initials: B
authors.lastname: Scheffler
authors.forename: Thomas
authors.initials: T
authors.lastname: Heinrichsmeier
authors.forename: Joachim
authors.initials: J
authors.lastname: von Oertzen
authors.forename: Thomas
authors.initials: T
authors.lastname: Kral
authors.forename: Joerg
authors.initials: J
authors.lastname: Wellmer
authors.forename: Johannes
authors.initials: J
authors.lastname: Schramm
authors.forename: Otmar D
authors.initials: OD
authors.lastname: Wiestler
authors.forename: Ingmar
authors.initials: I
authors.lastname: Blümcke
mesh_terms: D000293:Adolescent; D000328:Adult; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000473:pathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome