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Cerebral Hemispheres

Cerebral Hemispheres

The human brain, a complex organ, is functionally divided into two cerebral hemispheres—left and right. These hemispheres are interconnected by a structure of paramount importance, the corpus callosum. This substantial bundle of neural fibers is not just a bridge between the hemispheres but a crucial element for the brain's comprehensive functioning. It enables efficient communication between the two hemispheres, allowing each side of the brain to control and receive sensory and motor...

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Updated: May 24, 2026

Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study

Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study

Published on: August 15, 2025

The periinsular functional hemispherotomy.

Leonardo Rangel-Castilla¹, Steven W Hwang, George Al-Shamy

¹Department of Neurosurgery, The Methodist Neurological Institute, Houston, Texas 77030, USA. lrcastilla@tmhs.org

Neurosurgical Focus

|March 3, 2012

Summary

This summary is machine-generated.

Periinsular hemispherotomy offers improved outcomes for refractory epilepsy by evolving from hemispherectomy. This surgical technique reduces complications while maintaining effective seizure control in patients.

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Published on: January 25, 2010

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Last Updated: May 24, 2026

Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study

Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study

Published on: August 15, 2025

Right Hemihepatectomy by Suprahilar Intrahepatic Transection of the Right Hemipedicle using a Vascular Stapler

Right Hemihepatectomy by Suprahilar Intrahepatic Transection of the Right Hemipedicle using a Vascular Stapler

Published on: January 25, 2010

Area of Science:

Neurosurgery
Epileptology
Pediatric Neurology

Background:

Refractory epilepsy treatment has advanced with surgical innovations.
Hemispherectomy, a disconnective procedure, has been refined.
Hemispherotomy now often replaces hemispherectomy due to lower complication rates and preserved seizure control.

Purpose of the Study:

To detail the anatomy and surgical technique of periinsular hemispherotomy.
To illustrate the operative steps involved in this specific hemispherotomy approach.
To discuss the complexities and challenges associated with periinsular hemispherotomy.

Main Methods:

Description of the lateral approach (periinsular hemispherectomy).
Involves modification of functional hemispherectomy.
Key steps include mesial temporal lobe removal, atrium exposure, internal capsule transection, callosotomy, and frontobasal disconnection.

Main Results:

The periinsular approach is a refined disconnective technique for epilepsy surgery.
It aims to minimize complications compared to traditional hemispherectomy.
Maintains good seizure control.

Conclusions:

Periinsular hemispherotomy is an advanced surgical option for refractory epilepsy.
Detailed understanding of anatomy and technique is crucial for successful outcomes.
This procedure represents an evolution in epilepsy surgical management.