Minimally invasive endoscopic transventricular hemispherotomy for medically intractable epilepsy a new approach and cadaveric demonstration

作者：Bahuleyan Biji; Manjila Sunil; Robinson Shenandoah; Cohen Alan R^*

来源：Journal of Neurosurgery-Pediatrics, 2010, 6(6): 536-540.

DOI：10.3171/2010.9.PEDS10267

• hemispherotomy
• endoscopic anatomy
• epilepsy
• minimally invasive neurosurgery

Object Surgery for medically intractable epilepsy secondary to unihemispheric pathology has evolved from more aggressive hemispherectomy to less aggressive variations of hemispherotomy The authors propose a novel minimally invasive endoscopic hemispherotomy that should give results comparable to conventional open craniotomy and microsurgery
Methods Endoscopic transventricular hemispherotomy was performed in 5 silicon injected cadaveric heads in the authors minimally Invasive neurosurgery laboratory The lateral ventricle was accessed endoscopically through a frontal and occipital bur hole White matter disconnections were performed to unroof the temporal horn and to disconnect the frontobasal region corpus callosum and fornix
Results Using an endoscopic transventricular approach all white matter disconnections were successfully performed in all 5 cadavers
Conclusions The authors have demonstrated the feasibility of endoscopic transventricular hemispherotomy in a cadaveric model The technique is simple and could be useful in a subgroup of patients with parenchymal volume loss and ventriculomegaly (DOI 10.3171/2010.9.PEDS10267)

• 出版日期2010-12