From Big Medical Encyclopedia

GIPPOKAMPOTOMIYA (a hippocampus + Greek tome a section, a section) — operation of removal or destruction of the gippokampovy crinkle which is a part of limbic system of a brain.

Fig. 1. The scheme of quick accesses at stereotaxic (a method of exact introduction to a brain of electrodes, surgical instruments) gippokampotomiya: front access — dashed lines; back access — a solid line; 1 — the hippocampus projected on the lower horn of a side ventricle; 2 — an amygdaloid complex; 3 — front commissure of a brain; 4 — back commissure of a brain.
Fig. 2. The scheme of a temporal lobectomy (the resected site is shaded): 1 — an amygdaloid complex; 2 — the hippocampus projected on the lower horn of a side ventricle. At the left above scheme of operational access.

The main indication to this operation is temporal epilepsy (see). The volume of intervention is specified to or during operation on the basis of results of a research of bioelectric activity with use of cortical and subcortical assignments. Operation is carried out by a stereotaxic method (see. Stereotaxic neurosurgery ) or it can be made from front or side transventrikulyarny access. G. can sometimes be a part of a mediobazalny temporal lobectomy.

At stereotaxic interventions front access (fig. 1) which provides a possibility of a simultaneous research of bioelectric activity of an amygdaloid complex and rostral departments can be used hippocampus (see). However the direction of a trajectory of a submersible electrode on the steep line, in relation to a longitudinal axis of a paragippokampovy crinkle, limits assignment of biopotentials and the sizes of the center of destruction only to area of an arrangement of the active end of an electrode. At back access (fig. 1) the electrode is carried out along all longitudinal axis of a gippokampovy crinkle. Use in these cases of a multicontact electrode allows not only to make simultaneous registration of electric activity of various departments of a hippocampus, but also provides formation of the centers of destruction only in that area, in a cut at a subkortikografiya resistant epileptoidny activity comes to light.

At «open» interventions access to a gippokampovy crinkle is provided through a slit of a front third of an average temporal crinkle with opening of the lower horn of a side ventricle and removal of a part or all hippocampus. At a temporal lobectomy (fig. 2) delete with one block mediobazalny departments of a temporal share, an amigdalyarny complex and rostral departments of a hippocampus. All direct interventions on a hippocampus shall be carried out after preliminary specification of topography of the lower horn of a side ventricle by means of X-ray contrast methods of a research (see. Ventrikulografiya , Encephalography ).

N. Ya. Vasinonim