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Hemispherectomy: a schematic review of the current techniques
Antonio Nogueira De Almeida1, Raul Marino, Paulo Henrique Aguiar
1Departamento de Neurologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. almeidaan@globo.com
Neurosurgical Review
|February 8, 2006
Summary
Hemispherectomy, a surgical treatment for seizures, was modified to reduce complications while maintaining efficacy. This review classifies current hemispherectomy techniques to improve understanding and comparison.
Area of Science:
- Neurosurgery
- Epilepsy Surgery
Background:
- Anatomical hemispherectomy, used since 1938 for seizure treatment, faced near abandonment due to severe complications like hydrocephalus and hemosiderosis.
- Despite risks, significant patient improvements spurred modifications to enhance safety and preserve effectiveness.
Purpose of the Study:
- To review current hemispherectomy techniques.
- To propose a classification scheme for hemispherectomy procedures based on surgical characteristics.
Main Methods:
- Techniques were categorized into two main groups: complete cortical removal and partial cortical removal with disconnection.
- Further subdivisions were based on ventricular cavity integrity (Group 1) and corticectomy extent/location (Group 2).
Main Results:
- The proposed classification sorts hemispherectomy techniques into distinct groups and subgroups.
- This systematic grouping facilitates a clearer understanding of individual techniques' features.
Conclusions:
- Classifying hemispherectomy techniques aids in comparing data across different surgical approaches.
- Improved understanding of these techniques can lead to better patient outcomes in epilepsy surgery.