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Barrios-González DA, Gonzalez-Salido J, Colado-Martínez J, Philibert-Rosas S, Sotelo-Díaz F, Sebastián-Díaz MA, Gómez-Rodríguez LJ, Kerik-Rotenberg NE, Gutiérrez-Aceves GA, Martínez-Juárez IE. Unmasking the Mimic: Radionecrotic Lesion Masquerading as Brain Neoplasia on Magnetic Resonance Imaging. Cureus 2024; 16:e59259. [PMID: 38813315 PMCID: PMC11134471 DOI: 10.7759/cureus.59259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 05/31/2024] Open
Abstract
Corpus callosotomy is a therapeutic approach for drug-resistant epilepsy, with positive outcomes observed in managing atonic seizures. Despite a decline in its usage, radiosurgical callosotomy remains a viable option for drug-resistant epilepsy due to its low risks of post-radiation neoplasia, albeit not with exceptions. Brain radionecrosis is characterized by tissue death and vascular endothelial damage following the procedure. Despite the low risk of intracranial secondary malignancy associated with radiation in some cases, post-radiation lesions might present with distinct characteristics needing a thorough diagnostic approach. Herein, we present a unique case of a patient with focal epilepsy who developed a radionecrotic lesion following radiosurgical callosotomy, affecting the anterior cingulate cortex, and mimicking a central nervous system (CNS) tumor. Molecular imaging techniques, including 18-fluorodeoxyglucose positron emission tomography/computed tomography (18-FDG PET/CT) and 11C-acetate PET/CT scans, were employed to differentiate the lesion from a tumor. This case underscores the importance of considering radionecrosis as a differential diagnosis in patients who undergo radiosurgical callosotomy presenting with ring-like enhancement lesions on magnetic resonance imaging (MRI).
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Affiliation(s)
| | - Jimena Gonzalez-Salido
- Epilepsy Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico, Mexico City, MEX
| | | | | | - Fernando Sotelo-Díaz
- Neurosurgery Residency Program, National Institute of Neurology and Neurosurgery, Mexico, MEX
| | | | | | - Nora E Kerik-Rotenberg
- Molecular imaging unit, National Institute of Neurology and Neurosurgery, Mexico City , MEX
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Yindeedej V, Uda T, Kawashima T, Koh S, Tanoue Y, Kojima Y, Kunihiro N, Umaba R, Goto T. Use of an Endoscope Reduces the Size of Craniotomy Without Increasing Operative Time Compared With Conventional Microscopic Corpus Callosotomy. Oper Neurosurg (Hagerstown) 2023; 25:505-511. [PMID: 37578245 DOI: 10.1227/ons.0000000000000867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/12/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Corpus callosotomy (CC) is an epilepsy surgery that disconnects the commissural fibers at the corpus callosum, a structure that often plays a key role in propagating seizure activity. CC is particularly beneficial in patients with drop attacks. Less invasive endoscopic surgeries have recently been introduced to some fields of neurosurgery but have not yet become common in epilepsy surgery. Endoscopic surgeries offer better visualization and require a smaller corridor than conventional microscopic surgeries. Here, we presented a case series comparing endoscopic CC with microscopic CC. METHODS This 2-center retrospective study involved patients who underwent all types of CC (anterior, total, or posterior CC [pCC]) between January 2014 and May 2022. We excluded patients who underwent additional craniotomy for electrocorticography rather than CC, prior craniotomy, or CC without craniotomy. The primary outcomes were comparing size of craniotomy, operative time, and surgical complications between endoscopic CC and microscopic CC. RESULTS We included 14 CCs in 11 patients in the endoscopic group and 58 CCs in 55 patients in the microscopic group. No significant difference in age was seen between groups. Craniotomies were significantly smaller in the endoscopic group for anterior (13.36 ± 1.31 cm 2 vs 27.55 ± 3.78 cm 2 ; P = .001), total (14.07 ± 2.54 cm 2 vs 26.63 ± 6.97 cm 2 ; P = .001), and pCC (9.44 ± 1.18 cm 2 vs 30.23 ± 10.76 cm 2 ; P = .002). Moreover, no significant differences in operative time (anterior CC [261 ± 53.11 min vs 298.73 ± 81.08 min, P = .226], total CC [339.5 ± 48.2 min vs 321.39 ± 65.98 min, P = .452], pCC [198 ± 24.73 min vs 242.5 ± 59.12 min, P = .240]), or complication rate were seen. CONCLUSION Endoscopic CC is a promising technique requiring a smaller craniotomy than microscopic CC, without significantly increasing operative time or complication rate compared with microscopic CC.
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Affiliation(s)
- Vich Yindeedej
- Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
- Division of Neurosurgery, Department of Surgery, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Takehiro Uda
- Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Toshiyuki Kawashima
- Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Saya Koh
- Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Yuta Tanoue
- Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Yuichiro Kojima
- Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Noritsugu Kunihiro
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Ryoko Umaba
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Takeo Goto
- Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
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Hamdi H, Boissonneau S, Valton L, McGonigal A, Bartolomei F, Regis J. Radiosurgical Corpus Callosotomy for Intractable Epilepsy: Retrospective Long-Term Safety and Efficacy Assessment in 19 Patients an Review of the Literature. Neurosurgery 2023; 93:156-167. [PMID: 36861968 DOI: 10.1227/neu.0000000000002394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 12/06/2022] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Some patients suffering from intractable epileptic seizures, particularly drop attacks (DAs), are nonremediable by curative techniques. Palliative procedure carries a significant rate of surgical and neurological complications. OBJECTIVE To propose evaluation of safety and efficacy of Gamma Knife corpus callosotomy (GK-CC) as an alternative to microsurgical corpus callosotomy. METHODS This study included retrospective analysis of 19 patients who underwent GK-CC between 2005 and 2017. RESULTS Of the 19 patients, 13 (68%) had improvement in seizure control and 6 had no significant improvement. Of the 13/19 (68%) with improvement in seizures, 3 (16%) became completely seizure-free, 2 (11%) became free of DA and generalized tonic-clonic but with residual other seizures, 3 (16%) became free of DA only, and 5 (26%) had >50% reduction in frequency of all seizure types. In the 6 (31%) patients with no appreciable improvement, there were residual untreated commissural fibers and incomplete callosotomy rather than failure of Gamma Knife to disconnect. Seven patients showed a transient mild complication (37% of patients, 33% of the procedures). No permanent complication or neurological consequence was observed during the clinical and radiological workup with a mean of 89 (42-181) months, except 1 patient who had no improvement of epilepsy and then aggravation of the pre-existing cognitive and walking difficulties (Lennox-Gastaut). The median time of improvement after GK-CC was 3 (1-6) months. CONCLUSION Gamma Knife callosotomy is safe and accurate with comparable efficacy to open callosotomy in this cohort of patients with intractable epilepsy suffering from severe drop attacks.
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Affiliation(s)
- Hussein Hamdi
- Department of Functional Neurosurgery and Gamma Knife Radiosurgery, Timone University Hospital, Aix-Marseille University, APHM, CHU Timone, Marseille, France
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
- Functional and Stereotactic Unit, Neurological Surgery Department, Tanta University, Egypt
| | - Sébastien Boissonneau
- Department of Neurosurgery Aix-Marseille University, APHM, CHU Timone, Marseille, France
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - Luc Valton
- Department of Neurology, Hôpital PP Riquet-Purpan, Toulouse University Hospital, University of Toulouse, Toulouse, France
- Centre de Recherche Cerveau et Cognition (CerCo), UMR 5549, CNRS, Toulouse Mind and Brain Institute (TMBI), University of Toulouse, University Paul Sabatier, Toulouse, France
| | - Aileen McGonigal
- Department of Clinical Neurophysiology, APHM, APHM, CHU Timone, Marseille, France
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
- Department of Neurosciences, Mater Hospital, Brisbane and Faculty of Medicine, University of Queensland, Australia
| | - Fabrice Bartolomei
- Department of Clinical Neurophysiology, APHM, APHM, CHU Timone, Marseille, France
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - Jean Regis
- Department of Functional Neurosurgery and Gamma Knife Radiosurgery, Timone University Hospital, Aix-Marseille University, APHM, CHU Timone, Marseille, France
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
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Jelisejevs I, Upite J, Kalnins S, Jansone B. An Improved Surgical Approach for Complete Interhemispheric Corpus Callosotomy Combined with Extended Frontoparietal Craniotomy in Mice. Biomedicines 2023; 11:1782. [PMID: 37509422 PMCID: PMC10376606 DOI: 10.3390/biomedicines11071782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
Callosotomy is an invasive method that is used to study the role of interhemispheric functional connectivity in the brain. This surgical approach is technically demanding to perform in small laboratory animals, such as rodents, due to several methodological challenges. To date, there exist two main approaches for transecting the corpus callosum (CC) in rodents: trephine hole(s) or unilateral craniotomy, which cause damage to the cerebral cortex or the injury of large vessels, and may lead to intracranial hemorrhage and animal death. This study presents an improved surgical approach for complete corpus callosotomy in mice using an interhemispheric approach combined with bilateral and extended craniotomy across the midline. This study demonstrated that bilateral and extended craniotomy provided the visual space required for hemisphere and sinus retraction, thus keeping large blood vessels and surrounding brain structures intact under the surgical microscope using standardized surgical instruments. We also emphasized the importance of good post-operative care leading to an increase in overall animal survival following experimentation. This optimized surgical approach avoids extracallosal tissue and medium- to large-sized cerebral blood vessel damage in mice, which can provide higher study reproducibility/validity among animals when revealing the role of the CC in various neurological pathologies.
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Affiliation(s)
| | | | | | - Baiba Jansone
- Department of Pharmacology, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.J.); (J.U.); (S.K.)
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Guner YE, Comert A, Sayaci EY, Korkmaz AC, Gungor Y, Morali Guler T, Kahilogullari G, Savas A. Microsurgical anatomy of the anterior cerebral artery and the arterial supply of the cingulate gyrus. Surg Radiol Anat 2023; 45:351-358. [PMID: 36840818 DOI: 10.1007/s00276-023-03083-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/07/2023] [Indexed: 02/26/2023]
Abstract
PURPOSE The cingulate gyrus is a potential surgical area to treat tumours, psychiatric diseases, intractable pain and vascular malformations. The aim of the study was to define the topographic anatomy and arterial supply of the cingulate gyrus located on the medial surface of the cerebral hemisphere. METHODS We studied thirty-six hemispheres, each hemisected in the midsagittal plane. The vertical thickness of the cingulate gyrus was measured at the anterior commissure (AC), posterior commissure (PC), and genu levels of the corpus callosum. The branches of the anterior and posterior cerebral arteries supplying each zone were noted separately. The arterial pathways were transformed to digital data in AutoCAD to identify the condensation and reduction areas. RESULTS The mean AC-PC distance was 27.17 ± 1.63 mm. The thinnest region was the genu level of the corpus callosum (10.29 mm). The superior internal parietal artery (SIPA), inferior internal parietal artery (IIPA) and pericallosal artery (PrCA) supplied all zones of the cingulate gyrus. The anterior zone received the greatest supply. The arterial condensation and reduction areas on both sides of cingulate gyrus and its x, y, and z coordinates specified. CONCLUSIONS The target cingulotomy (TC) area was determined for anterior cingulotomy. The properties of the TC area are that the thinnest region of the cingulate gyrus is supplied relatively less than other areas and is close to the anterior cingulotomy areas in the literature. The arterial reduction area (ARA) was found to be suitable for corpus callosotomy in terms of avoiding haemorrhage.
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Affiliation(s)
- Yahya Efe Guner
- Department of Neurosurgery, School of Medicine, Yuksek Ihtisas University, Ankara, Turkey
| | - Ayhan Comert
- Department of Anatomy, School of Medicine, Ankara University, Ankara, Turkey.
| | - Emre Yagiz Sayaci
- Department of Neurosurgery, Memorial Ankara Hospital, Ankara, Turkey
| | - Ali Can Korkmaz
- Ministry of Health, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Yigit Gungor
- Department of Anatomy, School of Medicine, Ankara University, Ankara, Turkey
| | - Tugba Morali Guler
- Department of Neurosurgery, School of Medicine, Karabuk University, Karabuk, Turkey
| | - Gokmen Kahilogullari
- Department of Neurosurgery, School of Medicine, Ankara University, Ankara, Turkey
| | - Ali Savas
- Department of Neurosurgery, School of Medicine, Ankara University, Ankara, Turkey
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Hale AT, Barkley AS, Blount JP. Corpus Callosotomy Is a Safe and Effective Procedure for Medically Resistant Epilepsy. Adv Tech Stand Neurosurg 2023; 48:355-369. [PMID: 37770691 DOI: 10.1007/978-3-031-36785-4_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Corpus callosotomy (CC) is an effective surgical treatment for medically resistant generalized or multifocal epilepsy (MRE). The premise of CC extrapolates from the observation that the corpus callosum is the predominant commissural pathway that allows spread and synchroneity of epileptogenic activity between the hemispheres. Candidacy for CC is typically reserved for patients seeking palliative epilepsy treatment with the goal of reducing the frequency of drop attacks, although reduction of other seizure semiologies (absence, complex partial seizures, and tonic-clonic) has been observed. A reduction in morbidity affiliated with evolution of surgical techniques to perform CC has improved the safety profile of the procedure without necessarily sacrificing efficacy.
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Affiliation(s)
- Andrew T Hale
- Division of Pediatric Neurosurgery, Children's of Alabama, Birmingham, AL, USA
| | - Ariana S Barkley
- Division of Pediatric Neurosurgery, Children's of Alabama, Birmingham, AL, USA
| | - Jeffrey P Blount
- Division of Pediatric Neurosurgery, Children's of Alabama, Birmingham, AL, USA.
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Hasegawa D, Kanazono S, Chambers JK, Uchida K. Neurosurgery in feline epilepsy, including clinicopathology of feline epilepsy syndromes. Vet J 2022; 290:105928. [PMID: 36347391 DOI: 10.1016/j.tvjl.2022.105928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/07/2022]
Abstract
Feline epilepsy is treated with antiseizure medications, which achieves fair to good seizure control. However, a small subset of feline patients with drug-resistant epilepsy requires alternative therapies. Furthermore, approximately 50 % of cats with epileptic seizures are diagnosed with structural epilepsy with or without hippocampal abnormality and may respond to surgical intervention. The presence of hippocampal pathology and intracranial tumors is a key point to consider for surgical treatment. This review describes feline epilepsy syndrome and epilepsy-related pathology, and discusses the indications for and availability of neurosurgery, including lesionectomy, temporal lobectomy with hippocampectomy, and corpus callosotomy, for cats with different epilepsy types.
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Affiliation(s)
- Daisuke Hasegawa
- Laboratory of Veterinary Radiology, Nippon Veterinary and Life Science University, 1-7-1 Kyounancho, Musashino, Tokyo 180-8602, Japan; The Research Center for Animal Life Science, Nippon Veterinary and Life Science University, 1-7-1 Kyounancho, Musashino, Tokyo 180-8602, Japan.
| | - Shinichi Kanazono
- Neurology and Neurosurgery Service, Veterinary Specialists and Emergency Center, 815 Ishigami, Kawaguchi, Saitama 333-0823, Japan
| | - James K Chambers
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Kazuyuki Uchida
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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Corpus Callosotomy in the Modern Era: Origins, Efficacy, Technical Variations, Complications, and Indications. World Neurosurg 2022; 159:146-155. [PMID: 35033693 DOI: 10.1016/j.wneu.2022.01.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/08/2022] [Accepted: 01/09/2022] [Indexed: 11/23/2022]
Abstract
Corpus callosotomy is among the oldest surgeries performed for drug-resistant epilepsy (DRE). First performed in 1940, various studies have since assessed its outcomes in various patient populations in addition to describing different extents of sectioning and emerging technologies (i.e. endoscopic, laser interstitial thermal therapy, and radiosurgery). In order to capture the current state and offer a reappraisal, we comprehensively review corpus callosotomy's origins, efficacy for various seizure types, technical variations, complications, and indications and compare the procedure to vagus nerve stimulation therapy which has similar indications. We consider corpus callosotomy to be a safe and efficacious procedure that should be considered by clinicians when appropriate. Furthermore, it can also play an important role in treating patients with DRE in low-to-middle-income countries where resources are limited.
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Tripathi M, Deora H, Tripathi S, Ballari N. Role of gamma knife radiosurgery in the management of intracranial pathologies of pediatric population: Current concepts, limitations, and future directions. J Pediatr Neurosci 2022. [DOI: 10.4103/jpn.jpn_51_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Surgical Aspects of Corpus Callosotomy. Brain Sci 2021; 11:brainsci11121608. [PMID: 34942910 PMCID: PMC8699754 DOI: 10.3390/brainsci11121608] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022] Open
Abstract
Corpus callosotomy (CC) is one of the options in epilepsy surgeries to palliate patient seizures, and is typically applied for drop attacks. The mechanisms of seizure palliation involve disrupting the propagation of epileptic activity to the contralateral side of the brain. This review article focuses on the surgical aspects of CC. As a variations of CC, anterior two-thirds, posterior one-third, and total callosotomy are described with intraoperative photographs. As less-invasive surgical variations, recent progress in endoscopic CC, and CC without craniotomy, is described. CC remains acceptable under the low prevalence of complications, and surgeons should make the maximum effort to minimize the complication rate.
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Epilepsy Surgery is a Viable Treatment for Lennox Gastaut Syndrome. Semin Pediatr Neurol 2021; 38:100894. [PMID: 34183143 DOI: 10.1016/j.spen.2021.100894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 11/21/2022]
Abstract
Lennox Gastaut Syndrome (LGS) is a severe developmental epileptic encephalopathy with onset in childhood characterized by multiple seizure types and characteristic electroencephalogram findings. The majority of patients develop drug resistant epilepsy, defined as failure of 2 appropriate anti-seizure medications used at adequate doses. Epilepsy surgery can reduce seizure burden, in some cases leading to seizure freedom, and improve neuro-developmental outcomes and quality of life. Epilepsy surgery should be considered for all patients with drug resistant LGS. Herein, we review current surgical treatment options for patients with LGS, both definitive and palliative, including: focal cortical resection, vagus nerve stimulation and corpus callosotomy. Newer neuromodulation techniques will be explored, as well as the concept of LGS as a secondary network disorder.
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Postoperative Pneumocephalus on Computed Tomography Might Predict Post-Corpus Callosotomy Chemical Meningitis. Brain Sci 2021; 11:brainsci11050638. [PMID: 34063350 PMCID: PMC8156846 DOI: 10.3390/brainsci11050638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND A corpus callosotomy (CC) is a procedure in which the corpus callosum, the largest collection of commissural fibers in the brain, is disconnected to treat epileptic seizures. The occurrence of chemical meningitis has been reported in association with this procedure. We hypothesized that intraventricular pneumocephalus after CC surgery represents a risk factor for postoperative chemical meningitis. The purpose of this study was to analyze the potential risk factors for postoperative chemical meningitis in patients with medically intractable epilepsy who underwent a CC. METHODS Among the patients who underwent an anterior/total CC for medically intractable epilepsy between January 2009 and March 2021, participants were comprised of those who underwent a computed tomography scan on postoperative day 0. We statistically compared the groups with (c-Group) or without chemical meningitis (nc-Group) to determine the risk factors. RESULTS Of the 80 patients who underwent a CC, 65 patients (25 females and 40 males) met the inclusion criteria. Their age at the time of their CC procedure was 0-57 years. The c-Group (17%) was comprised of seven females and four males (age at the time of their CC procedure, 1-43 years), and the nc-Group (83%) was comprised of 18 females and 36 males (age at the time of their CC procedure, 0-57 years). Mann-Whitney U-tests (p = 0.002) and univariate logistic regression analysis (p = 0.001) showed a significant difference in pneumocephalus between the groups. CONCLUSION Postoperative pneumocephalus identified on a computed tomography scan is a risk factor for post-CC chemical meningitis.
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