title: Superficial cortical landmarks for localization of the hippocampus: Application for temporal lobectomy and amygdalohippocampectomy.
abstract: BACKGROUND
  Accessing the hippocampus for amygdalohippocampectomy and procedures such as depth electrode placement requires accurate knowledge regarding the location of the hippocampus.
  
  
  METHODS
  The authors removed 10 human cadaveric brains (20 sides) from their crania, noted relationships between the lateral temporal neocortex and underlying hippocampus, and measured the distance between the hippocampus and superficial landmarks.
  
  
  RESULTS
  Mean distances were as follows: 3.8 cm from the tip of the temporal lobe to the head of the hippocampus; 6.5 cm from the tip of the temporal lobe to the junction of the fornix and hippocampus; and 3.5 cm between the tail and head of the hippocampus. The head of the hippocampus ranged from 0 to 5 mm inferior to the inferior temporal sulcus. The tail of the hippocampus ranged from 2.2 to 7 mm superior to the inferior temporal sulcus. In two specimens, the tail was deep to the superior temporal sulcus. Generally the length of the hippocampus was along the inferior temporal sulcus and inferior aspect of the middle temporal gyrus. The hippocampus tended to be more superiorly located and shorter in females and left sides, but this was not statistically significant.
  
  
  CONCLUSIONS
  Additional landmarks for localizing the underlying hippocampus may be helpful in temporal lobe surgery. Our study showed relatively constant anatomic landmarks between the hippocampus and overlying temporal cortex that may help localize the hippocampus during amygdalohippocampectomy and depth electrode implantation, verify the accuracy of image-guided methods, and used as adjuvant methodologies when these latter technologies are unavailable.
authors.affiliation: Pediatric Neurosurgery, Children's Hospital of Alabama, Birmingham, Alabama, USA ; Department of Anatomic Sciences, St. George's University School of Medicine, St. George's, Grenada, UK ; Centre of Anatomy and Human Identification, University of Dundee, Scotland, UK.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.affiliation: Department of Anatomic Sciences, St. George's University School of Medicine, St. George's, Grenada, UK.
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
authors.affiliation: Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Barbaro
authors.affiliation: Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Cohen-Gadol
keywords: Anatomy; epilepsy surgery; hippocampectomy; landmarks; neurosurgery; temporal lobe