Jazayeri Mohammad-Ali, Jensen John N, Lew Sean M
Department of Neurosurgery, Medical College of Wisconsin/Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA.
J Neurosurg Pediatr. 2011 Nov;8(5):450-4. doi: 10.3171/2011.8.PEDS11176.
The authors report on the case of a 6-week-old boy who presented with infantile spasms. At 2.5 months of age, the patient underwent a right hemispherectomy. Approximately 3 months postoperatively, the patient presented with left coronal craniosynostosis. Subsequent cranial vault remodeling resulted in satisfactory cosmesis. Four years after surgery, the patient remains seizure free without the need for anticonvulsant medications. The authors believe this to be the first reported case of iatrogenic craniosynostosis due to hemispherectomy, and they describe 2 potential mechanisms for its development. This case suggests that, in the surgical treatment of infants with intractable epilepsy, minimization of brain volume loss through disconnection techniques should be considered, among other factors, when determining the best course of action.
作者报告了一名6周大患婴儿痉挛症男婴的病例。该患者在2.5个月大时接受了右半球切除术。术后约3个月，患者出现左冠状缝早闭。随后的颅骨重塑使美容效果令人满意。手术四年后，患者未再发作，无需使用抗惊厥药物。作者认为这是首例因半球切除术导致的医源性颅骨缝早闭病例，并描述了其发生发展的两种潜在机制。该病例表明，在治疗难治性癫痫婴儿时，确定最佳治疗方案时，除其他因素外，应考虑通过离断技术尽量减少脑容量损失。
