title: Delayed complications thirty-six years after hemispherectomy: a case report.
abstract: OBJECTIVE
  To describe a late complication of hemispherectomy in a patient in whom symptoms of hydrocephalus developed 36 years after her left-sided hemispherectomy, the longest delay on record.
  
  
  METHODS
  Hemispherectomy has been successfully used in the treatment of intractable epilepsy associated with infantile-type hemiplegia for a half century. Of the patients, however, up to 33% have late increased cerebrospinal fluid pressure complications attributed to superficial cerebral hemosiderosis. Through a retrospective case analysis, we describe such complications in a 52-year-old woman with cognitive impairment, gait instability, urinary incontinence, and right hemineglect 36 years after her initial procedure.
  
  
  RESULTS
  Quantitative, objective measures of cognition and gait-laboratory testing confirmed the patient's favorable clinical response to ventriculoperitoneal shunting, as well as the complete resolution of her symptoms, including the atypical occurrence of right-sided hemineglect.
  
  
  CONCLUSIONS
  This case uniquely demonstrates the clinical features of a late complication of hemispherectomy while documenting the longest reported delay for developing such adverse sequelae. We also emphasize the need for more extensive follow-up studies to assess the extent of posthemispherectomy complications.
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
authors.forename: S N
authors.initials: SN
authors.lastname: Kalkanis
authors.forename: H
authors.initials: H
authors.lastname: Blumenfeld
authors.forename: J C
authors.initials: JC
authors.lastname: Sherman
authors.forename: D E
authors.initials: DE
authors.lastname: Krebs
authors.forename: M C
authors.initials: MC
authors.lastname: Irizarry
authors.forename: S W
authors.initials: SW
authors.lastname: Parker
authors.forename: G R
authors.initials: GR
authors.lastname: Cosgrove
mesh_terms: D001921:Brain / Q000601:surgery*; D001927:Brain Diseases / Q000209:etiology; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006486:Hemosiderosis / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000209:etiology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt