title: Posterior callosotomy using a parietooccipital interhemispheric approach in the semi-prone park-bench position.
abstract: A 2-stage corpus callosotomy is accepted as a palliative procedure for patients older than 16 years with, in particular, medically intractable generalized epilepsy and drop attack seizures and is preferable for a lower risk of disconnection syndrome. Although the methods by which a previously performed craniotomy can be reopened for posterior callosotomy have already been reported, posterior corpus callosotomy using a parietooccipital interhemispheric approach with the patient in a semi-prone park-bench position has not been described in the literature. Here, the authors present a surgical technique for posterior callosotomy using a parietooccipital interhemispheric approach with a semi-prone park-bench position as a second surgery. Although this procedure requires an additional skin incision in the parietooccipital region, it makes the 2-stage callosotomy safer and easier to perform because of reduced intracranial adhesion, less bleeding, and an easier approach to the splenium of the corpus callosum.
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Ito
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
authors.forename: Michiharu
authors.initials: M
authors.lastname: Morino
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Niimura
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Takamizawa
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Shimizu
mesh_terms: D000293:Adolescent; D000328:Adult; D003337:Corpus Callosum / Q000601:surgery*; D000069279:Drug Resistant Epilepsy / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D009778:Occipital Lobe / Q000601:surgery*; D010296:Parietal Lobe / Q000601:surgery*; D056888:Patient Positioning / Q000379:methods*; D061214:Patient Safety; D011183:Postoperative Complications / Q000453:epidemiology; D016684:Prone Position; D012640:Seizures / Q000601:surgery; D013575:Syncope / Q000601:surgery; D055815:Young Adult
keywords: VNS = vagus nerve stimulation; epilepsy surgery; posterior corpus callosotomy; surgical approach; surgical technique