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Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection

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Burr Hole Hemispherotomy: Case Series.

Michael E Baumgartner¹, Kathleen Galligan², Tracy M Flanders^2,3

¹The Perelman School of Medicine at the University of Pennsylvania, Philadelphia , Pennsylvania , USA.

Operative Neurosurgery (Hagerstown, Md.)

|March 5, 2025

Summary

This study introduces a minimally invasive burr hole hemispherotomy for drug-resistant epilepsy. The procedure achieved complete disconnection and significantly reduced seizures in pediatric patients, offering a safer alternative to traditional craniotomy.

Keywords:

Burr hole Epilepsy Hemispherectomy Hemispherotomy Minimally invasive

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Microvascular Decompression: Salient Surgical Principles and Technical Nuances

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Published on: July 5, 2011

Area of Science:

Neurosurgery
Epilepsy Research
Minimally Invasive Procedures

Background:

Hemispherotomy is a definitive treatment for severe unilateral epilepsy.
Traditional open craniotomy carries significant risks including infection, blood loss, and prolonged recovery.
A novel, minimally invasive approach using a single burr hole is presented.

Purpose of the Study:

To evaluate the safety and efficacy of a minimally invasive burr hole hemispherotomy technique.
To present the initial outcomes of the first cohort of patients undergoing this procedure.

Main Methods:

Retrospective analysis of 7 patients who underwent burr hole hemispherotomy.
Data collected included demographics, operative details, complications, and seizure control.
Procedure performed through a 15-18 mm burr hole, targeting the Sylvian fissure.

Main Results:

Complete hemispheric disconnection achieved in all 7 patients.
Minimal blood loss (mean 25.7 cc) and no perioperative transfusions or deaths.
71% of patients achieved Engel Class IA outcome (seizure freedom).

Conclusions:

Burr hole hemispherotomy is a viable surgical approach for epilepsy.
This minimally invasive technique demonstrates a favorable risk profile and efficacy.
The procedure offers a promising alternative to open craniotomy for selected patients.