Vertical Parasagittal Hemispherotomy in a Pediatric Case of Epilepsy Due to Rasmussen Encephalitis: 2-Dimensional Operative Video

Authors

Alessandro De Benedictis, Neurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Chiara Pepi, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, IRCCS, European Reference Network EpiCARE, Rome, Italy.
Aalap Herur-Raman, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Matteo Barba, Neurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Alessandra Marasi, Functional and Interventional Neuroradiology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Maria Camilla Rossi-Espagnet, Neuroradiology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Antonio Napolitano, Medical Physics Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Sabrina Rossi, Pathology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Davide Luglietto, Neurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Sergio Capelli, Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Caterina Zanus, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
Alessandra Savioli, Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Luca de Palma, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, IRCCS, European Reference Network EpiCARE, Rome, Italy.
Nicola Specchio, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, IRCCS, European Reference Network EpiCARE, Rome, Italy.
Carlo Efisio Marras, Neurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Document Type

Journal Article

Publication Date

7-5-2024

Journal

Operative neurosurgery (Hagerstown, Md.)

DOI

10.1227/ons.0000000000001261

Abstract

Hemispherotomy is an effective disconnection technique for the treatment of different forms of drug-resistant epilepsy due to encephalopathies with unilateral hemispheric involvement.1-8 We describe the case of a 6-year-old child affected by Rasmussen encephalitis who underwent right vertical parasagittal hemispherotomy.9 The goal of the procedure was to isolate the basal ganglia region by interrupting the interhemispheric and intrahemispheric white matter connectivity. The main surgical steps include the transcortical approach to the lateral ventricle, the posterior callosotomy, the fimbria-fornix incision, the laterothalamic vertical incision, the anterior callosotomy, the frontobasal disconnection, and the transcaudate lateral incision to the anterior temporal horn.7,10 At 10-month follow-up, the patient was seizure free with a stable left hemiparesis. The antiepileptic therapy was progressively interrupted. The video describes the main surgical steps, using both intraoperative videos and advanced three-dimensional modeling of neuroimaging pictures. Patient' parents consented to the procedure. The participants and any identifiable individuals consented to publication of his/her image. Approval from the ethics committee was acquired.

APA Citation

De Benedictis, Alessandro; Pepi, Chiara; Herur-Raman, Aalap; Barba, Matteo; Marasi, Alessandra; Rossi-Espagnet, Maria Camilla; Napolitano, Antonio; Rossi, Sabrina; Luglietto, Davide; Capelli, Sergio; Zanus, Caterina; Savioli, Alessandra; de Palma, Luca; Specchio, Nicola; and Marras, Carlo Efisio, "Vertical Parasagittal Hemispherotomy in a Pediatric Case of Epilepsy Due to Rasmussen Encephalitis: 2-Dimensional Operative Video" (2024). GW Authored Works. Paper 5321.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5321

Department

School of Medicine and Health Sciences Student Works