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Imaging for optimized detection of hippocampal sclerosis:

Thin slice volumetric T1-weighted images, axial and coronal T2-weighted and FLAIR images.

Imaging characteristics of hippocampal sclerosis:
  • hippocampal atrophy
  • hippocampal signal change (high T2 and FLAIR signal)
  • changes may be seen in nearby structures, known as mesial temporal sclerosis
  • up to one third of patients have dual pathology (hippocampal sclerosis co-existing with other structural brain abnormalities), these should be carefully sought
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