The fornix in patients with seizures caused by unilateral hippocampal sclerosis: detection of unilateral volume loss on MR images.

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Abstract
Because some of the axons of the fornix originate in the pyramidal cells of the hippocampus, we hypothesize that neuronal loss within the hippocampus may result in wallerian degeneration and subsequent atrophy of the ipsilateral fornix. Using high-resolution MR imaging, we evaluated the size of the fornix in patients who had lateralizing partial complex temporal lobe seizures after unilateral hippocampal sclerosis. The expectation is that unilateral forniceal atrophy will provide an additional, objective imaging criterion for determining the side of seizure involvement.We retrospectively reviewed preoperative MR images of 13 patients with temporal lobe epilepsy who subsequently had unilateral hippocampal sclerosis proved surgically. The images were obtained with specially designed bilateral phased-array coils that permitted high-resolution (512 x 512, 16-cm field of view) T2-weighted fast spin-echo imaging of oblique coronal sections. The width of each rostral crus of the fornix was measured by three neur...

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