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Delayed complications thirty-six years after hemispherectomy: a case report
S N Kalkanis1, H Blumenfeld, J C Sherman
1Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
Epilepsia
|August 1, 1996
Summary
A rare late complication of hemispherectomy, hydrocephalus, developed 36 years after surgery in a patient. Ventriculoperitoneal shunting resolved symptoms, highlighting the need for long-term patient monitoring.
Area of Science:
- Neurosurgery
- Neurology
- Epilepsy Management
Background:
- Hemispherectomy is a long-standing treatment for intractable epilepsy.
- Late complications, including increased cerebrospinal fluid pressure due to superficial cerebral hemosiderosis, affect up to 33% of patients.
Observation:
- A 52-year-old woman presented with hydrocephalus 36 years post-left hemispherectomy.
- Symptoms included cognitive decline, gait issues, incontinence, and right hemineglect.
Findings:
- Ventriculoperitoneal shunting led to complete symptom resolution.
- Cognitive and gait assessments confirmed positive outcomes.
Implications:
- This case represents the longest documented delay for post-hemispherectomy hydrocephalus.
- Extended follow-up is crucial for identifying and managing late hemispherectomy complications.