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Hemispherectomy: a schematic review of the current techniques

Neurosurgical Review volume 29, pages 97–102 (2006)Cite this article

An Erratum to this article was published on 24 May 2006

Abstract

Anatomical hemispherectomy has been used for the treatment of seizures since 1938. However, it was almost abandoned in the 1960s after reports of postoperative fatalities caused by hydrocephalus, hemosiderosis, and trivial head traumas. Despite serious complications, the remarkable improvement of patients encouraged authors to carry out modifications on anatomical hemispherectomy in order to lessen its morbidity while preserving its efficacy. The effort to improve the technique generated several original procedures. This paper reviews current techniques of hemispherectomy and proposes a classification scheme based on their surgical characteristics. Techniques of hemispherectomy were sorted into two major groups: (1) those that remove completely the cortex from the hemisphere and (2) those that associate partial cortical removal and disconnection. Group 1 was subdivided into two subgroups based on the integrity of the ventricular cavity and group 2 was subdivided into three subgroups depending on the amount and location of the corticectomy. Grouping similar techniques may allow a better understanding of the distinctive features of each one and creates the possibility of comparing data from different authors.

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Affiliations

  1. Departamento de Neurologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Antonio Nogueira De Almeida, Raul Marino Jr., Paulo Henrique Aguiar & Manoel Jacobsen Teixeira

  2. Instituto Neurológico de São Paulo, Rua Maestro Cardim, 808, Liberdade, CEP 01323-001, São Paulo, SP, Brazil

    Antonio Nogueira De Almeida

Authors
  1. Antonio Nogueira De Almeida
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  2. Raul Marino Jr.
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  3. Paulo Henrique Aguiar
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  4. Manoel Jacobsen Teixeira
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Correspondence to Antonio Nogueira De Almeida.

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Comment

Johannes Schramm

Bonn, Germany

This is a very concise review of available hemispherectomy and hemispherotomy techniques which is very nicely illustrated. Although this very specialised surgical techniques will be of interest only to a minority of neurosurgeons, this review nicely summarises the advantages of the modern methods to perform a functional hemispherectomy which consists of more disconnection and less resection. Our own series also reflects this tendency with only 19 cases using Rasmussen’s functional hemispherectomy technique but over 60 cases using similar techniques as the authors have done in their own series (R. T. Daniel et al. 2001). The reader who wants to get an overview about currently available techniques which are much less invasive finds here a very concise and well illustrated article

An erratum to this article can be found at http://dx.doi.org/10.1007/s10143-006-0026-8

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Nogueira De Almeida, A., Marino, R., Aguiar, P.H. et al. Hemispherectomy: a schematic review of the current techniques. Neurosurg Rev 29, 97–102 (2006). https://doi.org/10.1007/s10143-005-0011-7

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Keywords

  • Epilepsy surgery
  • Hemispherectomy
  • Hemispherotomy
  • Hemidecortication
  • Hemicorticectomy