Hemispherectomy: A hemidecortication approach and review of 52 cases

Benjamin S. Carson, Sam P. Javedan, John M. Freeman, Eileen P.G. Vining, Aaron L. Zuckerberg, Jeremy A. Lauer, Michael Guarnieri

Research output: Contribution to journalArticle

Abstract

Between 1975 and 1994, 52 hemispherectomies, of which two were anatomical and 50 hemidecortications, were performed at Johns Hopkins Medical Institutions. Eighteen patients were 2 years old or less. There were three perioperative mortalities and one patient died 9 months later from causes not related to surgery. One patient developed hydrocephalus 6 years postsurgery and has been treated effectively. Seizure control and the functional status of each patient were measured as outcome variables. Forty-six (96%) of the surviving patients were seizure free or had reduced seizures as of their last follow-up examination. Twenty-one individuals (44%) were participating in age-appropriate classes or working independently. 18 were classified as semiindependent, and nine children will likely depend on a lifetime of assisted living. The relationships between the outcome variables and the patient's age at surgery, the interval to surgery, and the etiology of the disease were compared. The authors' clinical experiences strongly suggest the importance of a multidisciplinary approach to patient selection and follow- up care. Moreover, anesthetic management of infant surgery is a major component of success.

Original languageEnglish (US)
Pages (from-to)903-911
Number of pages9
JournalJournal of neurosurgery
Volume84
Issue number6
DOIs
StatePublished - Jun 1996

Keywords

  • Rasmussen's syndrome
  • developmental syndrome
  • hemidecortication
  • hemispherectomy
  • pediatric epilepsy surgery
  • vascular syndrome

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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  • Cite this

    Carson, B. S., Javedan, S. P., Freeman, J. M., Vining, E. P. G., Zuckerberg, A. L., Lauer, J. A., & Guarnieri, M. (1996). Hemispherectomy: A hemidecortication approach and review of 52 cases. Journal of neurosurgery, 84(6), 903-911. https://doi.org/10.3171/jns.1996.84.6.0903