Hemispherectomy for Seizures Revisited

Canadian Journal of Neurological Sciences - Tập 10 Số 2 - Trang 71-78 - 1983
T Rasmussen1
1Montreal Neurological Institute and Hospital

Tóm tắt

SUMMARY:The serious, late complication of superficial cerebral hemosiderosis, which appears after several years in 1/4–1/3 of patients who have undergone hemispherectomy, has resulted in recent years in a considerable reluctance to carry out this operation despite the fact it has proved to be highly effective in patients with medically refractory seizures associated with hemiplegia. Preservation of a small portion of the hemisphere, usually the frontal or occipital pole, has proved to be effective in preventing this late complication, but at the cost of a significant reduction in the effectiveness of the operation in reducing the patients’ seizure tendency. Preserving the frontal and occipital poles but disconnecting them from the rest of the brain, resulting in a functional complete but anatomical subtotal hemispherectomy, retains the therapeutic effectiveness of a complete hemispherectomy while still protecting adequately against the serious late postoperative complication of superficial cerebral hemosiderosis and its associated neurologic deterioration, hydrocephalus and sometimes death.

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Tài liệu tham khảo

10.1136/jnnp.29.3.229

10.1212/WNL.32.6.629

10.1159/000104492

Rasmussen, 1973, Postoperative superficial hemosiderosis of the brain, its diagnosis, treatment and prevention, Trans. Am. Neur. Assn, 98, 133

10.1111/j.1469-8749.1967.tb02363.x

10.1007/BF01814021

10.1001/jama.1928.02690380007003

10.1136/jnnp.13.4.243

10.3171/jns.1969.30.4.0413

McKenzie, 1938, Proc. Amer. Med. Assn, 111, 168

Carlson, 1968, A reexamination of intellectual disabilities in hemispherectomized patients, Tr. Amer. Neurol. Assn, 93, 198

10.1097/00005072-196007000-00010

Lhermitte, 1928, L’ablation complète de l’hémisphère droit dans les cas de tumeur cérébrale localisée compliquée d’hémiplégie: la décérébration suprathalamique unilatérale chez l’homme, Encéphal, 23, 314

10.1093/brain/93.1.147

10.1111/j.1469-8749.1969.tb01447.x

Ransohoff, 1954, Hemispherectomy in the treatment of convulsive seizures associated with infantile hemiplegia, Res. Publ. Ass. Nerv. Ment. Dis, 34, 176

Laine, 1956, 134

Gros C. and Vlahovitch B. (1955). L’hèmisphérectomie cérébrale. Imprimerie Causse, Graille et Castelnau. Montpellier, 113 pp.

McKissock, 1953, Infantile hemiplegia, Proc. Royal Soc. Med, 46, 431, 10.1177/003591575304600607

Laine, 1964, Résultats éloignés de l’hèmisphérectomie dans les cas d’hémiatrophie cérébrale infantile génératrice d’épilepsie, Neuro-Chirug, 10, 507

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Canadian Journal of Neurological Sciences

Tập 10 Số 2

71-78

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