PubMed · 13720763
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R N DE NIORD. 1960. Decortication for empyema and hemothorax.. https://pubmed.ncbi.nlm.nih.gov/13720763/
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Hemispherectomy, or hemidecorticectomy as it is more accurately described, has been highly effective in reducing or eliminating medically intractable seizures associated with hemiplegia. Because of late onset postoperative superficial cerebral hemosiderosis and its associated neurologic deterioration, this procedure was all but abandoned for years. With improved surgical techniques and diagnostic testing, some medical centers with a special interest in epilepsy are again using hemispherectomy as a treatment for uncontrolled seizures associated with Rasmussen's encephalitis, as well as other etiologies. Specialized nursing care throughout the hospital course is essential to a positive outcome for the patient and family.
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Neurosurgical procedures of established value in the treatment of the medically intractable epilepsies include temporal lobectomy, extratemporal cortical excision, hemispherectomy, and corpus callosotomy. The clinical decision to consider surgery in children with epilepsy requires an understanding of the natural history of pediatric seizures, the constraints of the presurgical evaluation, and the relationship between surgical outcome and tissue pathology. This article presents an overview of the indications, risks, and benefits of epilepsy surgery in the pediatric population.