Sorano V, Esposito S
Department of Neurosurgery, S. Giovanni Hospital, Rome, Italy.
Childs Nerv Syst. 1998 Sep;14(9):440-7. doi: 10.1007/s003810050257.
Hemispherectomy has had excellent results in treating drug-resistant seizures of infantile hemiplegia, except for the vulnerability of the remaining hemisphere. The hemispherectomy cavity has been considered responsible for early and late complications. Modified techniques have been widely performed and are not without complications. CNS hemosiderosis is probably not the only explanation; the craniocerebral disproportion following the surgery, the shunt effect and low pressure of the cavity should also be taken into account. Splinting the remaining hemisphere to avoid its dislodgment could be important. One of our patients who suffered a series of complications hitherto unreported in the literature was eventually treated with a filling-reduction cranioplasty. The rationale for the technique can be inferred from the literature reviewed in the article. Our technique is validated by a follow-up of 28 years since the hemispherectomy and 13 years since treatment for complications.
除了剩余半球的脆弱性外，大脑半球切除术在治疗婴儿偏瘫的耐药性癫痫方面取得了优异的效果。大脑半球切除腔被认为是早期和晚期并发症的原因。改良技术已被广泛应用，但并非没有并发症。中枢神经系统含铁血黄素沉着症可能不是唯一的解释；手术后脑颅骨比例失调、分流效应和腔隙低压也应予以考虑。固定剩余半球以避免其移位可能很重要。我们的一名患者出现了一系列文献中迄今未报道的并发症，最终接受了填充-减压颅骨成形术治疗。该技术的原理可以从本文综述的文献中推断出来。自大脑半球切除术后28年以及并发症治疗后13年的随访验证了我们的技术。
