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Related Experiment Video

Updated: Jun 25, 2025

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection

Published on: April 12, 2024

Vertical Parasagittal Hemispherotomy.

Vich Yindeedej¹, Takehiro Uda², Noritsugu Kunihiro³

¹Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan; Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan; Division of Neurosurgery, Department of Surgery, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.

World Neurosurgery

|May 29, 2024

Summary

Hemispherotomy offers a refined surgical approach for hemispheric epilepsy, disconnecting specific brain pathways while preserving tissue. This vertical parasagittal technique simplifies access and reduces operative time.

Keywords:

Hemispherotomy Parasagittal Superior frontal gyrus removal Vertical

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Published on: August 16, 2024

Area of Science:

Neurosurgery
Epileptology
Pediatric Neurology

Background:

Hemispherotomy is a complex epilepsy surgery disconnecting brain fibers.
It preserves brain parenchyma, unlike hemispherectomy.
Vertical hemispherotomy offers advantages over lateral approaches.

Purpose of the Study:

To present surgical steps for vertical parasagittal hemispherotomy.
To detail a modified approach using partial superior frontal gyrus removal.
To illustrate the procedure in a pediatric case of hemimegalencephaly.

Main Methods:

Vertical hemispherotomy via a parasagittal approach.
Partial superior frontal gyrus removal to widen the surgical field.
Disconnection of commissural, projecting, and limbic fibers.

Main Results:

The modified parasagittal approach facilitates surgical access.
Reduced operative time and craniotomy size are potential benefits.
Successful application in a 5-month-old infant with hemimegalencephaly.

Conclusions:

Vertical parasagittal hemispherotomy is a viable surgical option for hemispheric epilepsy.
Partial superior frontal gyrus removal enhances surgical efficiency.
This technique is applicable in complex pediatric epilepsy cases.