Corticotomy closure avoids subdural collections after hemispherotomy.

Area of Science:

• Neurosurgery
• Pediatric Neurosurgery
• Surgical Innovation

Background:

• Subdural collection is a recognized complication following hemispherotomy procedures.
• Peri-insular hemispherotomy is a surgical intervention for specific neurological conditions in children.
• Minimizing adverse events is crucial in pediatric neurosurgery.

Purpose of the Study:

• To present a novel surgical technique aimed at preventing subdural collection after peri-insular hemispherotomy.
• To evaluate the efficacy of this technique in a pediatric cohort.
• To address a significant postoperative complication in epilepsy surgery.

Main Methods:

• The study involved 16 pediatric patients undergoing peri-insular hemispherotomy.
• A specific technique of closing the corticotomy using interrupted pial sutures and fibrinogen glue was employed since 2008.
• Surgical outcomes were monitored for the occurrence of subdural collection and hydrocephalus.

Main Results:

• The implemented surgical technique successfully eliminated postoperative subdural collections in all treated patients.
• No increase in the incidence of postoperative hydrocephalus was observed with this method.
• The technique proved effective in managing a key complication of hemispherotomy.

Conclusions:

• Closing the ventricular access after functional hemispherotomy is recommended.
• This technique is particularly beneficial for pediatric patients, especially those with a history of stroke.
• The described method offers a safe and effective approach to mitigate subdural collection post-hemispherotomy.