{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:41:30Z","timestamp":1792806090576,"version":"4.5.0"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Anteromesial temporal lobe resection (ATLR) results in long-term seizure freedom in patients with drug-resistant focal mesial temporal lobe epilepsy (MTLE). There is significant anatomical variation in the anterior projection of the optic radiation (OR), known as Meyer\u2019s loop, between individuals and between hemispheres in the same individual. Damage to the OR results in contralateral superior temporal quadrantanopia that may preclude driving in 33%\u201366% of patients who achieve seizure freedom. Tractography of the OR has been shown to prevent visual field deficit (VFD) when surgery is performed in an interventional MRI (iMRI) suite. Because access to iMRI is limited at most centers, the authors investigated whether use of a neuronavigation system with a microscope overlay in a conventional theater is sufficient to prevent significant VFD during ATLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Twenty patients with drug-resistant MTLE who underwent ATLR (9 underwent right-side ATLR, and 9 were male) were recruited to participate in this single-center prospective cohort study. Tractography of the OR was performed with preoperative 3-T multishell diffusion data that were overlaid onto the surgical field by using a conventional neuronavigation system linked to a surgical microscope. Phantom testing confirmed overlay projection errors of &lt; 1 mm. VFD was quantified preoperatively and 3 to 12 months postoperatively by using Humphrey and Esterman perimetry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Perimetry results were available for all patients postoperatively, but for only 11\/20 (55%) patients preoperatively. In 1\/20 (5%) patients, a significant VFD occurred that would prevent driving in the UK on the basis of the results on Esterman perimetry. The VFD was identified early in the series, despite the surgical approach not transgressing OR tractography, and was subsequently found to be due to retraction injury. Tractography was also used from this point onward to inform retractor placement, and no further significant VFDs occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Use of OR tractography with overlay outside of an iMRI suite, with application of an appropriate error margin, can be used during approach to the temporal horn of the lateral ventricle and carries a 5% risk of VFD that is significant enough to preclude driving postoperatively. OR tractography can also be used to inform retractor placement. These results warrant a larger prospective comparative study of the use of OR tractography\u2013guided mesial temporal resection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2020.12.jns203437","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T21:19:21Z","timestamp":1644009561000},"page":"543-552","source":"Crossref","is-referenced-by-count":8,"title":["Intraoperative overlay of optic radiation tractography during anteromesial temporal resection: a prospective validation study"],"prefix":"10.3171","volume":"136","author":[{"given":"Vejay N.","family":"Vakharia","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy, University College London and Epilepsy Society MRI Unit, London;"},{"name":"National Hospital for Neurology and Neurosurgery, Queen Square, London;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sjoerd B.","family":"Vos","sequence":"additional","affiliation":[{"name":"Wellcome\/EPSRC Centre for Interventional and Surgical Sciences, University College London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin P.","family":"Winston","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy, University College London and Epilepsy Society MRI Unit, London;"},{"name":"National Hospital for Neurology and Neurosurgery, Queen Square, London;"},{"name":"Department of Medicine, Division of Neurology, Queen\u2019s University, Kingston, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Gutman","sequence":"additional","affiliation":[{"name":"Alfred Health, Melbourne, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Wykes","sequence":"additional","affiliation":[{"name":"Institute of Cancer and Genomic Sciences, University of Birmingham;"},{"name":"Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew W.","family":"McEvoy","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy, University College London and Epilepsy Society MRI Unit, London;"},{"name":"National Hospital for Neurology and Neurosurgery, Queen Square, London;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Miserocchi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy, University College London and Epilepsy Society MRI Unit, London;"},{"name":"National Hospital for Neurology and Neurosurgery, Queen Square, London;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Sparks","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences, St Thomas\u2019 Hospital, King\u2019s College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Ourselin","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences, St Thomas\u2019 Hospital, King\u2019s College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy, University College London and Epilepsy Society MRI Unit, London;"},{"name":"National Hospital for Neurology and Neurosurgery, Queen Square, London;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1056\/NEJM200108023450501","article-title":"A randomized, controlled trial of surgery for temporal-lobe epilepsy","volume":"345","author":"Wiebe S","year":"2001","unstructured":"Wiebe S, Blume WT, Girvin JP, Eliasziw M. 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