Functional hemispherectomy

Functional Hemispherectomy is a neurosurgical procedure that involves the disconnection of one hemisphere of the brain. This procedure is typically performed to treat a variety of seizure disorders, where seizures are not adequately controlled by anticonvulsant medication.

History

The first functional hemispherectomy was performed in the 1920s by the American neurosurgeon Walter Dandy. The procedure has since evolved, with modifications made to reduce complications and improve patient outcomes.

Procedure

In a functional hemispherectomy, the neurosurgeon disconnects the affected hemisphere from the rest of the brain. This is done by severing the corpus callosum, which connects the two hemispheres, and removing or disconnecting the affected hemisphere's cerebral cortex. The remaining hemisphere then takes over the functions of the disconnected hemisphere.

Indications

Functional hemispherectomy is typically indicated for patients with severe seizure disorders that are localized to one hemisphere of the brain. These may include conditions such as Rasmussen's encephalitis, Sturge-Weber syndrome, and Hemimegalencephaly.

Risks and Complications

As with any surgical procedure, functional hemispherectomy carries risks. These may include infection, bleeding, and complications from anesthesia. Neurological complications may also occur, including hemiplegia (paralysis on one side of the body), hemianopsia (loss of half of the visual field), and cognitive or language deficits.

Prognosis

The prognosis following functional hemispherectomy varies depending on the underlying condition, the patient's age, and the extent of the brain's plasticity. Many patients experience a significant reduction in seizure frequency and severity. Some may also experience improvements in cognitive and motor function.

See Also

• Hemispherectomy
• Epilepsy surgery
• Neurosurgery