FUNCTIONAL HEMISPHERECTOMY

TYPES

There are two types of hemispherectomies that surgeons can perform on their patients. These are:

•  Anatomic hemispherectomy

This type of hemispherectomy is performed by removing the frontal, parietal, temporal, and occipital lobes.

Deeper parts of the brain are left behind, such as the basal ganglia, thalamus, and brain stem. This hemispherectomy type has a higher risk of delayed hydrocephalus. The blood loss is commonly done to patients suffering from hemimegalencephaly.

• Functional hemispherectomy

Functional hemispherectomy involves removing a small portion of the brain’s affected side, thus detaching the remaining brain tissue.

It includes the disconnection of corpus callosotomy resulting in the seclusion of electrical activity in the affected hemisphere that causes a seizure.

Functional hemispherectomy has a lower risk of hydrocephalus and blood loss; however, this surgery is not suited for every patient.

SYMPTOMS

A week after the surgery, the patient might experience some side effects. Usually, these symptoms will slowly diminish, and these include:

• Headaches
• Tiredness
• Nausea
• Puffy eyes
• Feeling depressed
• Having a hard time finding the right words
• Difficulty in concentrating
• Forgetfulness
• Numbness in your scalp
• Muscle weakness

DIAGNOSIS

A candidate for operation will have to undergo a lot of tests; these tests will enable the doctor to find where the seizure is originating.

• Scans: The patient will undergo an MRI, PET scan, and other kinds of brain tests. 
• Video EEG monitoring: In this test, the doctor will record your brain waves by making the patient wear a transmitter in conjunction with recording a video of what they are doing, like sleeping, watching tv, or any activity. It enables the doctor to compare their brain wave activity with what they are doing and when their seizure episode starts.
• Wada test: Wada test checks the patient’s speech and memory on the brain, one side at a time. It will take their doctor to determine which side of their brain has better memory or control their speech ability. The test result will help the doctor compare it to other test results and enable him to locate where their seizure starts. This test also tells the doctor if the patient will need to be awake at a certain part of their surgery.

TREATMENT

After the surgery, the patient will be in the intensive care unit (ICU) for a couple of days and be moved to a hospital room for a few more days. The staples or stitches made from the surgery will be removed after 10 to 14 days after the operation.