Format

Send to

Choose Destination
Childs Nerv Syst. 2019 Jul;35(7):1245-1249. doi: 10.1007/s00381-019-04171-7. Epub 2019 May 2.

A child with a stroke, drug-refractory epilepsy and congenital heart disease: can a hemispherectomy be safely performed between staged cardiac procedures?

Author information

1
Epilepsy Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, M5G 1X8, Canada.
2
Division of Pediatric Neurology, Department of Pediatrics, BL Kapur (BLK) Super Speciality Hospital, Pusa Road, New Delhi, 110005, India.
3
Division of Cardiac Surgery, The Hospital for Sick Children, Toronto, M5G 1X8, Canada.
4
Stroke Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, M5G 1X8, Canada.
5
Labatt Family Heart Center, The Hospital for Sick Children, Toronto, M5G 1X8, Canada.
6
Department of Anesthesia, The Hospital for Sick Children, Toronto, M5G 1X8, Canada.
7
Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, M5G 1X8, Canada. george.ibrahim@sickkids.ca.

Abstract

BACKGROUND:

The safety of hemispherectomy between staged cardiac procedures is unknown and not previously reported.

METHOD:

Retrospective review of a case with drug-resistant epilepsy due to stroke following bidirectional cavopulmonary connection (BDCPC).

RESULTS:

This report describes the first case of a successful pediatric peri-insular functional hemispherectomy in the setting of a BDCPC. A discussion of the complex preoperative planning from both a cardiac and neurological perspective is presented. Considerations regarding hemispherectomy and its effects on the cardiac physiology, and perioperative considerations are emphasized in clinical decision making.

CONCLUSIONS:

A multidisciplinary approach was critical in this child which led to a successful outcome.

KEYWORDS:

Cardiac surgery; Cardioembolic stroke; Congenital heart disease; Disconnection; Epilepsy surgery; Single ventricle

PMID:
31044297
DOI:
10.1007/s00381-019-04171-7

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center