Skip to main content

Advertisement

SpringerLink
Log in

A child with a stroke, drug-refractory epilepsy and congenital heart disease: can a hemispherectomy be safely performed between staged cardiac procedures?

  • Case Report
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Background

The safety of hemispherectomy between staged cardiac procedures is unknown and not previously reported.

Method

Retrospective review of a case with drug-resistant epilepsy due to stroke following bidirectional cavopulmonary connection (BDCPC).

Results

This report describes the first case of a successful pediatric peri-insular functional hemispherectomy in the setting of a BDCPC. A discussion of the complex preoperative planning from both a cardiac and neurological perspective is presented. Considerations regarding hemispherectomy and its effects on the cardiac physiology, and perioperative considerations are emphasized in clinical decision making.

Conclusions

A multidisciplinary approach was critical in this child which led to a successful outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Scavarda D, Major P, Lortie A, Mercier C, Carmant L (2009) Periinsular hemispherotomy in children with stroke-induced refractory epilepsy. J Neurosurg Pediatr 3:115–120

    Article  PubMed  Google Scholar 

  2. Moosa AN, Jehi L, Marashly A, Cosmo G, Lachhwani D, Wyllie E, Kotagal P, Bingaman W, Gupta A (2013) Long-term functional outcomes and their predictors after hemispherectomy in 115 children. Epilepsia 54:1771–1779

    Article  PubMed  Google Scholar 

  3. Kotani Y, Honjo O, Shani K, Merklinger SL, Caldarone C, Van Arsdell G (2012) Is indexed preoperative superior vena cava blood flow a risk factor in patients undergoing bidirectional cavopulmonary shunt? Ann Thorac Surg 94:1578–1583

    Article  PubMed  Google Scholar 

  4. Monagle P, Chan AKC, Goldenberg NA, Ichord RN, Journeycake JM, Nowak-Göttl U, Vesely SK (2012) Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141:e737S–e801S

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Roach ES, Golomb MR, Adams R, Biller J, Daniels S, Deveber G, Ferriero D, Jones BV, Kirkham FJ, Scott RM, Smith ER, American Heart Association StrokeCouncil; Council on Cardiovascular Disease in the Young (2008) Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke 39:2644–2691

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Epilepsy Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, M5G 1X8, Canada

    Puneet Jain, Ayako Ochi & Shelly K. Weiss

  2. Division of Pediatric Neurology, Department of Pediatrics, BL Kapur (BLK) Super Speciality Hospital, Pusa Road, New Delhi, 110005, India

    Puneet Jain

  3. Division of Cardiac Surgery, The Hospital for Sick Children, Toronto, M5G 1X8, Canada

    Christoph Haller

  4. Stroke Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, M5G 1X8, Canada

    Elizabeth Pulcine

  5. Labatt Family Heart Center, The Hospital for Sick Children, Toronto, M5G 1X8, Canada

    Anne Dipchand

  6. Department of Anesthesia, The Hospital for Sick Children, Toronto, M5G 1X8, Canada

    Vannessa Chin

  7. Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, M5G 1X8, Canada

    George M. Ibrahim

Authors
  1. Puneet Jain
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christoph Haller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elizabeth Pulcine
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ayako Ochi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anne Dipchand
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shelly K. Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Vannessa Chin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. George M. Ibrahim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to George M. Ibrahim.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics

Informed written consent was obtained from the parents of the reported case as per the hospital guidelines.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jain, P., Haller, C., Pulcine, E. et al. A child with a stroke, drug-refractory epilepsy and congenital heart disease: can a hemispherectomy be safely performed between staged cardiac procedures?. Childs Nerv Syst 35, 1245–1249 (2019). https://doi.org/10.1007/s00381-019-04171-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-019-04171-7

Keywords

Search

Navigation