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Functional hemispherectomy

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https://www.readbyqxmd.com/read/30090755/hemispherotomy-and-functional-hemispherectomy-indications-and-outcomes
#1
REVIEW
Ju-Seong Kim, Eun-Kyung Park, Kyu-Won Shim, Dong Seok Kim
Hemispherectomy constitutes an established surgical method in the management of patients with medically intractable epilepsy secondary to severe unilateral hemisphere damage. As opposed to focal resections, in hemispherotomies, the entire hemisphere is disconnected from the remaining nervous system, including the functional regions and fibers. Despite this, hemispherotomy is recommended for certain indications, and has good functional and epilepsy outcomes. Here we describe the indications, epilepsy outcomes, and surgical techniques for several hemispheric surgeries...
June 2018: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/30010070/pre-surgical-thalamus-and-brainstem-shifts-predict-distal-motor-function-recovery-after-anatomical-hemispherectomy
#2
Xiuyu Du, Sichang Chen, Yuguang Guan, Jingjing Gu, Meng Zhao, Tianfu Li, Junhong Pan, Guoming Luan
BACKGROUND: Anatomical hemispherectomy is an effective surgical treatment for patients with intractable epilepsy who suffer from severe hemisphere lesions. Different degrees of brain shifting have been observed, but whether these shifts could predict motor function recovery is unknown. The aim of this study was to analyse the correlation between the brain shift ratios of different brain areas and motor function before and after anatomical hemispherectomy. METHODS: The medical records and MRI scans of twenty-three patients who underwent anatomical hemispherectomy from 2006 to 2013 at a single centre were retrospectively reviewed...
July 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29969591/functional-reorganization-of-population-receptive-fields-in-a-hemispherectomy-patient-with-blindsight
#3
Loraine Georgy, Bert Jans, Marco Tamietto, Alain Ptito
Blindsight refers to the ability of some patients with destruction of the primary visual cortex (V1) to respond to stimuli presented in their clinically blind visual field despite lack of visual awareness. Here we tested a rare and well-known patient with blindsight following hemispherectomy, DR, who has had the entire cortex in the right hemisphere removed, and in whom the right superior colliculus is the only post-chiasmatic visual structure remaining intact. Compared to more traditional cases of blindsight after damage confined to V1, the study of blindsight in hemispherectomy has offered the invaluable opportunity to examine directly two outstanding questions: the contribution of the intact hemisphere to visual processing without awareness, and the nature of plastic and compensatory changes in these remaining contralesional visual areas...
June 30, 2018: Neuropsychologia
https://www.readbyqxmd.com/read/29954815/assessing-corticospinal-tract-asymmetry-in-unilateral-polymicrogyria
#4
O Foesleitner, K-H Nenning, T Traub-Weidinger, M Feucht, S Bonelli, T Czech, C Dorfer, D Prayer, G Kasprian
BACKGROUND AND PURPOSE: Asymmetry of the corticospinal tract in congenital lesions is a good prognostic marker for preserved motor function after hemispherectomy. This study aimed to assess this marker and provide a clinically feasible approach in selected cases of unilateral polymicrogyria. MATERIALS AND METHODS: Corticospinal tract asymmetry of 9 patients with unilateral polymicrogyria substantially affecting the central region was retrospectively assessed on axial T1WI and DTI...
June 28, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29899784/hemimegalencephaly-seizure-outcome-in-an-infant-after-hemispherectomy
#5
Prem Chand, Pooja Manglani, Qalab Abbas
Isolated hemimegalencephaly (iHME) is a rare form of congenital malformation of cortical development characterized by enlargement of all or part of one cerebral hemisphere. It typically presents with intractable seizures, developmental delay, contralateral hemiparesis, and hemianopia. We report a case of an 18-month-old girl who presented first with focal seizures at tenth day of life, with no other physical or behavioral abnormality. Initial EEG showed excessive sharp EEG transients more over the right hemisphere; repeated EEG showed spikes, polyspikes, sharps, and slow wave discharges predominately over the right hemisphere...
January 2018: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29882701/a-new-model-of-experimental-hemispherotomy-in-young-adult-rattus-norvegicus-a-neural-tract-tracing-and-spect-in-vivo-study
#6
Ivair Matias, Daoud Hibrahim Elias-Filho, Camila Araújo Bernardino Garcia, Guilherme Henrique Silva, Jorge Mejia, Francisco Romero Cabral, Ana Cláudia Camargo Miranda, Sérgio Gomes da Silva, Luíza da Silva Lopes, Norberto Cysne Coimbra, Hélio Rubens Machado
OBJECTIVE The objective of this study was to describe a new experimental model of hemispherotomy performed on laboratory animals. METHODS Twenty-six male young adult Wistar rats were distributed into two groups (surgery and control). The nonfluorescent anterograde neurotracer biotinylated dextran amine (BDA; 10,000 MW) was microinjected into the motor cortex area (M1) according to The Rat Brain in Stereotaxic Coordinates atlas to identify pathways and fibers disconnected after the experimental hemispherectomy...
June 8, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29777895/asymmetry-of-cerebral-peduncles-for-predicting-motor-function-restoration-in-young-patients-before-hemispherectomy
#7
Xiu-Yu Du, Si-Chang Chen, Yu-Guang Guan, Jing-Jing Gu, Meng Zhao, Tian-Fu Li, Jun-Hong Pan, Guo-Ming Luan
OBJECTIVE: Hemispherectomy has been used successfully for patients with medically intractable epilepsy. However, it is difficult to predict postoperative motor function. The aim of the present study was to analyze whether the preoperative asymmetry of cerebral peduncles could be used to predict motor function restoration before hemispherectomy for young patients with medically intractable epilepsy. METHODS: The clinical record and magnetic resonance imaging data of 53 patients were analyzed retrospectively...
August 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29692973/visual-hallucinations-a-novel-complication-after-hemispherectomy
#8
Jonas Vanags, Monisha Sachdev, Gerald Grant, Mohamad A Mikati
Two patients at our center experienced florid visual hallucinations following hemispherectomy. The first patient had drug-resistant left hemispheric focal seizures at 20 months of age from a previous stroke. Following functional hemispherectomy at age 3, he experienced frightening hallucinations 1 month post-operatively lasting 3.5 months. Our second patient underwent subtotal hemispherectomy at age 6 for drug-resistant focal seizures from right hemispheric cortical dysplasia. Eighteen months later he developed scary visual hallucinations during which he would shout and throw things...
2018: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/29673722/density-spectral-array-of-bis-vista%C3%A2-monitoring-system-in-a-functional-hemispherectomy
#9
C Luis, E Vilà, L Moltó, A Pardo, J L Fernández Candila, S Pacreu
We present the case of an adult patient with drug-resistant epilepsy caused by extensive inflammation in the right cerebral hemisphere. She was scheduled to undergo right functional hemispherectomy, which is common in pediatric surgery, but about which few studies have been published with respect to adult patients. During the intraoperative period, the density spectral array of the bilateral bispectral index (BIS) VISTATM monitoring system was used. We observed a power increase in low frequency (0.1-4Hz) and alpha bands (8-12Hz) in the right hemisphere, where the epileptogenic focus was...
April 16, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29672310/significance-of-fdg-pet-hypermetabolism-in-children-with-intractable-focal-epilepsy
#10
Solon Schur, Victoria Allen, Andrew White, David Mirsky, Nicholas Stence, Brent O'Neill, Michael Handler, Roy Dudley, Pramote Laoprasert
BACKGROUND: Interictal 18F-fluorodeoxyglucose-positron emission topography (FDG-PET) hypometabolism is routinely used in the presurgical workup of children with medically intractable epilepsy (MIE). FDG-PET hypermetabolism, however, is rarely seen, and the significance of this finding in the epilepsy workup is not well established. METHODS: We performed a retrospective study of patients who underwent FDG-PET during the presurgical workup of MIE over a 4-year period, between 1 January 2010 and 31 December 2013, at the Children's Hospital Colorado, CO, USA...
2018: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29564536/long-term-neurocognitive-improvement-after-late-right-hemispherectomy-case-report-and-review-of-the-literature
#11
Alessandra Moletto, Irene Bagnasco, Patrizia Dassi, Piernanda Vigliano
OBJECTIVE: To study the long-term neurocognitive changes of a right-handed girl with intractable epilepsy after late right hemispherectomy and compare them with data in the literature. METHOD: The girl was affected by an epileptic encephalopathy associated with right fronto-temporo-parietal polymicrogyria; she was submitted to right hemispherectomy at the age of 5 and examined with cognitive and neuropsychological tests at the age of 17 years. The girl took advantage of neurocognitive rehabilitation for several years; she is currently seizure-free and off therapy...
August 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29480510/-functional-hemispherectomy-long-term-follow-up-in-a-series-of-five-patients
#12
X Rodriguez-Osorio, F J Lopez-Gonzalez, J Eiris-Punal, C Frieiro-Dantas, C Gomez-Lado, M Peleteiro-Fernandez, A Prieto-Gonzalez
INTRODUCTION: Functional hemispherectomy consists in palliative epilepsy surgical procedure usually performed in patients with pharmaco-resistant epilepsy and hemispheric syndromes. It is based on the neural disconnection of the affected hemisphere with preservation of the vascular supply. AIM: To analyze long-term prognosis and safety of the hemispherectomies performed in our institution. PATIENTS AND METHODS: Retrospective analysis collecting the following variables: age, gender, age of epilepsy onset, type of seizures, etiology, age of epilepsy surgery, prognosis and potential surgical complications...
March 1, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29210884/discrepancy-between-cerebral-structure-and-cognitive-functioning-a-review
#13
REVIEW
Michael Nahm, David Rousseau, Bruce Greyson
Neuroscientists typically assume that human mental functions are generated by the brain and that its structural elements, including the different cell layers and tissues that form the neocortex, play specific roles in this complex process. Different functional units are thought to complement one another to create an integrated self-awareness or episodic memory. Still, findings that pertain to brain dysplasia and brain lesions indicate that in some individuals there is a considerable discrepancy between the cerebral structures and cognitive functioning...
December 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/29167751/diffusion-tensor-imaging-in-an-infant-undergoing-functional-hemispherectomy-a-surgical-aid
#14
Allen L Ho, Arjun V Pendharkar, Eric S Sussman, May Casazza, Gerald A Grant
Hemispherectomy is a highly effective treatment option for children with severe, unilateral, medically refractory epilepsy. Many patients undergoing hemispherectomy are younger patients with dysmorphic brains, making accomplishing a complete disconnection challenging due to anatomic distortion, even with the aid of intraoperative navigation. Diffusion tensor imaging (DTI) has been proposed as a valuable imaging adjunct perioperatively to help guide surgeons intraoperatively, as well as for post-surgical evaluation and confirmation of complete hemispheric disconnection...
September 18, 2017: Curēus
https://www.readbyqxmd.com/read/29159066/six-adult-patients-with-septo-optic-dysplasia-and-drug-resistant-epilepsy-clinical-findings-and-course
#15
Mashael AlKhateeb, Richard McLachlan, Jorge Burneo, David Diosy, Seyed Mirsattari
Septo-optic dysplasia (SOD) is a rare disorder associated with optic nerve hypoplasia, pituitary abnormalities and agenesis/dysgenesis of midline brain structures including the septum pellucidum and corpus callosum. Though sometimes associated with drug-resistant epilepsy, this association has not been well studied. We report six SOD patients with associated malformation of cortical development (MCD) and drug-resistant epilepsy who underwent video-EEG telemetry at our centre between 1998 and 2016 for drug-resistant epilepsy...
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/29099351/corticospinal-tract-atrophy-and-motor-fmri-predict-motor-preservation-after-functional-cerebral-hemispherectomy
#16
Anthony C Wang, George M Ibrahim, Andrew V Poliakov, Page I Wang, Aria Fallah, Gary W Mathern, Robert T Buckley, Kelly Collins, Alexander G Weil, Hillary A Shurtleff, Molly H Warner, Francisco A Perez, Dennis W Shaw, Jason N Wright, Russell P Saneto, Edward J Novotny, Amy Lee, Samuel R Browd, Jeffrey G Ojemann
OBJECTIVE The potential loss of motor function after cerebral hemispherectomy is a common cause of anguish for patients, their families, and their physicians. The deficits these patients face are individually unique, but as a whole they provide a framework to understand the mechanisms underlying cortical reorganization of motor function. This study investigated whether preoperative functional MRI (fMRI) and diffusion tensor imaging (DTI) could predict the postoperative preservation of hand motor function. METHODS Thirteen independent reviewers analyzed sensorimotor fMRI and colored fractional anisotropy (CoFA)-DTI maps in 25 patients undergoing functional hemispherectomy for treatment of intractable seizures...
January 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29091250/functional-hemispherectomy-for-adult-rasmussen-encephalitis-a-case-report-and-literature-review
#17
Qun Wang, Zhanpeng Zhu, Guangming Wang, Lichao Sun, Jiqing Qiu
BACKGROUND: Rasmussen encephalitis (RE) is a rare and severe brain disorder associated with unilateral hemispheric atrophy, manifesting as severe refractory epilepsy, hemiplegia, defects of motor and speech functions, and cognitive impairment. Treatment of RE, especially in adult patients, is extremely challenging. Herein, we report the case of an adult patient with RE who was treated with a functional hemispherectomy and achieved a favorable prognosis. CASE REPORT: A 29-year-old woman presented with a 24-year history of epileptic seizures...
September 26, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29073473/functional-hemispherectomy-is-safe-and-effective-in-adult-patients-with-epilepsy
#18
Barbara Schmeiser, Josef Zentner, Bernhard Jochen Steinhoff, Andreas Schulze-Bonhage, Evangelos Kogias, Anne-Sophie Wendling, Thilo Hammen
INTRODUCTION: Functional hemispherectomy (FH) is a well-established therapeutic option for children with epilepsy with parenchymal damage confined to one hemisphere, yet its application in adults remains rare. The intention of our study was to investigate postoperative clinical and epileptological outcome in adults who received FH for intractable epilepsy. MATERIALS AND METHODS: We retrospectively analyzed 12 adult patients (18-56years) with intractable epilepsy due to unihemispheric pathology...
December 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28973550/case-report-free-latissimus-dorsi-flap-in-combination-with-subdural-space-reduction-for-the-prevention-of-recurrent-hemorrhage-following-hemispherectomy
#19
Carolyn M Benson, Holger Joswig, H Brian Evans, David A Steven
BACKGROUND AND IMPORTANCE: Extensive cerebral resections for the treatment of epilepsy may result in a large intracranial dead space that is prone to recurrent hemorrhage, either due to mechanical dislodgement or the development of extensive subdural membranes. Several techniques have been proposed to decrease the risk of hemorrhage by either reducing or filling the remaining intracranial dead space. CLINICAL PRESENTATION: We present a case of persistent hemorrhage following functional hemispherectomy in a patient with a large porencephalic cyst...
June 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28841860/usefulness-of-intraoperative-insular-electrocorticography-in-modified-functional-hemispherectomy
#20
Gun-Ha Kim, Joo Hee Seo, James E Baumgartner, Fatima Ajmal, Ki Hyeong Lee
BACKGROUND: The insular cortex is not routinely removed in modified functional hemispherectomy due to the risk of injury to the main arteries and to deep structures. Our study evaluates the safety and usefulness of applying intraoperative electrocorticography (ECoG) on the insular during the hemispherectomy. METHODS: We included all patients who underwent insular ECoG during a modified functional hemispherectomy from 2012 to 2015. After the surgery, the decision for further resection of the insular cortex was made based on the presence of electrographic seizures on ECoG...
August 25, 2017: BMC Neurology
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