Show pageBacklinksCite current pageExport to PDFBack to top This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong. [[Functional hemispherectomy]]/[[hemispherotomy]] is a [[disconnection procedure]] for [[severe medically refractory epilepsy]] where the seizure foci diffusely localize to one [[hemisphere]]. It is an improvement on anatomical [[hemispherectomy]] and was first performed by Rasmussen in [[1974]]. Less invasive surgical approaches and refinements have been made to improve seizure freedom and minimize surgical [[morbidity]] and [[complication]]s. Key anatomical structures that are disconnected include the 1) [[internal capsule]] and [[corona radiata]], 2) [[mesial temporal]] structures, 3) [[insula]], 4) [[corpus callosum]], 5) [[parietooccipital connection]], and 6) frontobasal connection. A stepwise approach is indicated to ensure adequate [[disconnection]] and prevent seizure persistence or recurrence. In young pediatric patients, careful patient selection and modern surgical techniques have resulted in > 80% seizure freedom and very good functional outcome. Young et al. summarized the history of [[hemispherectomy]] and its development and present a graphical guide for this anatomically challenging procedure. The use of the [[osteoplastic]] flap to improve outcome and the management of [[hydrocephalus]] are discussed ((Young CC, Williams JR, Feroze AH, McGrath M, Ravanpay AC, Ellenbogen RG, Ojemann JG, Hauptman JS. Pediatric functional hemispherectomy: operative techniques and complication avoidance. Neurosurg Focus. 2020 Apr 1;48(4):E9. doi: 10.3171/2020.1.FOCUS19889. PubMed PMID: 32234987. )). parietooccipital_connection.txt Last modified: 2024/06/07 02:51by 127.0.0.1