Persistent intracranial bleeding as a complication of hemispherectomy.

Oppenheimer, D. R.; Griffith, Huw B.

doi:10.1136/jnnp.29.3.229

Cited by 175 publications

(65 citation statements)

References 5 publications

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“…5,18 Additionally, there was a clear delay in hemispherectomy cases between the procedure and the onset of symptoms, despite the presence of subarachnoid hemorrhage detected by lumbar puncture after surgery. 8,19 As a result, diagnosis of superficial siderosis is difficult and may be delayed, unless the treating physician is aware of the possibility. 17 We know of only 2 cases of superficial siderosis after a CSF diversion procedure in the English-language literature.…”

Section: Discussionmentioning

confidence: 99%

“…5 Apart from idiopathic cases, 10 the underlying causes of superficial siderosis have included intracranial brain tumor, spinal tumor, cerebral aneurysm, vascular malformation, and cervical root avulsion. 5,14 Iatrogenic superficial siderosis has also been reported following hemispherectomy, 19 spinal decompressive surgery, 4 and posterior fossa surgery. 1,13,16 Ventriculoperitoneal shunt surgery is the most common procedure performed in most neurosurgical centers for the treatment of hydrocephalus.…”

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confidence: 99%

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Superficial siderosis of the central nervous system after ventriculoperitoneal shunt

Satow

Yamada²,

Yagi³

et al. 2010

JNS

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The authors report a case of superficial siderosis of the CNS that developed after ventriculoperitoneal (VP) shunt placement for normal-pressure hydrocephalus.A 65-year-old woman had undergone VP shunt insertion for normal-pressure hydrocephalus. Her gait disturbance, memory disturbance, and urinary incontinence all improved after the procedure. Two years later, however, her gait became ataxic and her appetite became poor. Brain MR imaging revealed a rim of hypointensity on T2-weighted sequences, enveloping the surface of the cortical fissure, cerebellum, and brainstem. Superficial siderosis of the CNS was diagnosed. Steroid administration improved her symptoms.The authors know of only one case of superficial siderosis developing after VP shunt surgery in the Englishlanguage literature. Superficial siderosis should be acknowledged as a possible complication of VP shunt. (DOI: 10.3171/2009.11.JNS091228) keY worDs • superficial siderosis • ventriculoperitoneal shunt • complication 93Abbreviations used in this paper: NPH = normal-pressure hydrocephalus; VP = ventriculoperitoneal.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Superficial siderosis of the central nervous system after ventriculoperitoneal shunt

Satow

Yamada²,

Yagi³

et al. 2010

JNS

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“…Due to working space limitations within the ventricles, patients with hemimegalencephaly are likely to be at a higher risk of inadequate disconnection. 14 …”

Section: Residual Seizures and Potential Reasons For Suboptimal Discomentioning

confidence: 99%

“…As many as 33% of patients developed this condition at a median of 8 years after the procedure. 11,14,18 Superficial siderosis occurs as a consequence of chronic granular ependymitis associated with multiple bleeding areas on the membrane that replaces the resected hemisphere in continuity with the ventricular system, leading to neurological decline, hydrocephalus, and in many cases, death.…”

Section: Historical Perspectives and Evolution Of Techniquesmentioning

confidence: 99%

Modified periinsular hemispherotomy: operative anatomy and technical nuances

Kovanda

Rey‐Dios

Trávnícek

et al. 2014

PED

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Surgical options for pediatric patients with marked dysfunction of a single epileptogenic hemisphere have evolved over time. Complications resulting from highly resective operations such as anatomical hemispherectomy, including superficial siderosis and secondary hydrocephalus, have led to the development of less resective and more disconnective functional hemispherectomy. Functional hemispherectomy has recently given rise to hemispherotomy, the least resective operation primarily aimed at disconnecting the abnormal hemisphere. Hemispherotomy is effective in decreasing seizure frequency and most likely decreases the risk of postoperative complications when compared with its predecessors. Hemispherotomy is a technically challenging operation that requires a thorough understanding of 3D cerebral anatomy to ensure adequate hemispheric disconnection without placing important structures at risk. The details of germane operative anatomy are not currently available because of the difficulty in exposing this operative anatomy adequately in cadavers to prepare detailed instructive illustrations. Using 3D graphic models, the authors have prepared 2D overlay illustrations to discuss the relevant operative nuances for a modified form of this procedure. Through hemispherotomy, experienced surgeons can effectively treat patients with unilateral epileptogenic hemisphere dysfunction while limiting potential complications.

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“…2,12,17 Yet after a report by Oppen heimer and Griffith in 1960 that described delayed mor talities due to superficial hemosiderosis, the technique of anatomical hemispherectomy fell out of favor. 20 Accord ingly, to avoid superficial hemosiderosis, other surgical techniques were developed. Functional hemispherectomy was devised by Ras mussen in 1974.…”

Section: Historical Overviewmentioning

confidence: 99%