Corpus callosotomy in children with intractable epilepsy using frameless stereotactic neuronavigation: 12-year experience at the Hospital for Sick Children in Toronto.
Neurosurg Focus
; 25(3): E7, 2008 Sep.
Article
en En
| MEDLINE
| ID: mdl-18759631
ABSTRACT
OBJECT Although corpus callosotomy has been used effectively since the late 1930s to treat severe, medically intractable seizure disorders, particularly atonic or drop-attack seizures, controversy remains as to when, how, and how much surgery should be performed. Intraoperative determination of the extent of callosotomy, the need to stage the procedure, and the side of the interhemispheric approach represent technical issues that remain debatable. The authors report the 12-year experience of the senior author as well as surgical outcomes with corpus callosotomy using a frameless stereotactic neuronavigation system (ISG View Wand and BrainLab). METHODS:
Thirteen consecutive children at The Hospital for Sick Children underwent single-stage corpus callosotomy for medically intractable seizures. The mean age was 10.3 years. Five children underwent partial callosotomy, and 8 underwent complete callosotomy. The side of operative approach to avoid large parasagittal bridging veins was determined by preoperative study of 3D MR imaging/MR venography reconstructed by the neuronavigation system. The extent of callosotomy was determined using intraoperative feedback from the neuronavigation system and postoperative MR imaging.RESULTS:
The extent of callosotomy determined by intraoperative neuronavigation and postoperative MR imaging correlated closely in all cases. There were no operative deaths. There was no significant postoperative morbidity related to venous infarction. Four of 5 patients in the partial callosotomy cohort and 7 of 8 patients in the complete callosotomy cohort showed significant improvement in seizure control.CONCLUSIONS:
The use of frameless stereotactic neuronavigation is a safe, effective, and important surgical adjunct in the planning and execution of successful corpus callosotomy in children with intractable epilepsy.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Cuerpo Calloso
/
Neuronavegación
/
Epilepsia
/
Hospitales Pediátricos
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Neurosurg Focus
Asunto de la revista:
NEUROCIRURGIA
Año:
2008
Tipo del documento:
Article
País de afiliación:
Estados Unidos