Is there a role for unilateral hippocampal sparing?  

There is some lateralization of hippocampus function which may impact decision making.The left hippocampus seems to play more of a role in episodic verbal memory, while the right plays more of a role in spatial processing. Our neurosurgeon has told me before that a left hippocampectomy is much worse...

There is no level one evidence to support unilateral hippocampal sparing; however, I believe it is a reasonable consideration for those patients not amenable to SRS, but with one or more lesions within one hippocampal avoidance zone, but no lesions in close proximity to the other. We offer this to ...

For many decades, it has been common to remove one hippocampus in patients with intractable seizures. Functional outcomes are remarkably good*. However, in 1953, a surgeon removed *both* hippocampi in a young man with seizures arising from both hippocampi. That patient (labeled H.M., his real initia...

Related - newer data showing the association between cognitive outcomes (MMSE only) and left, rather than right, hippocampal dose in GBM patients receiving conventionally fractionated vs short course RT. Might provide additional motivation for sparing at least left hippocampus when both are not feas...

Our institution does not offer unilateral hippocampal sparing because the phase III NRG-CC001 trial of WBRT plus memantine without (WBRT+M) or with hippocampal avoidance (HAWBRT+M) excluded patients with lesions within 5mm of either hippocampus. Per Gondi et al in the 2018 ASTRO abstract, neuro-cogn...