Peri-insular hemispherotomy: potential pitfalls and avoidance of complications.
Techniques for cerebral hemispherectomy have progressively evolved towards more disconnection and less excision over the last 50 years. Peri-insular hemispherotomy (PIH), as described by the senior author, has the maximal ratio of disconnection to excision among all procedures for hemispheric epilepsy. In this study, we focus on surgical complications and intraoperative anatomical observations during PIH over the last 10 years. Based on this experience, the procedure has undergone some modifications, which we detail herein.
Daniel
Roy Thomas
RT
Service de Neurochirurgie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. roymercy@hotmail.com
Villemure
Jean Guy
JG
D000293:Adolescent; D002540:Cerebral Cortex / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009493:Neurosurgery / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed