Overview of a Functional Hemispherectomy

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Anatomy of the Brain

The human brain is divided into two hemispheres, the left and the right, and they are connected with each other by a band of nerves known as the corpus callusom. Each hemisphere of the brain contains four lobes, namely, the frontal lobe, occipital lobe, parietal lobe and temporal lobes. It is said that different types of thinking occur in each hemisphere. For example, the right hemisphere is responsible for intuitive and subjective thinking, while the left side is involved with objective and logical thinking.

Functional Hemispherectomy Overview

Functional hemispherectomy is a type of surgical procedure that removes certain portions of the brain’s hemisphere which is not functioning well. This surgical procedure often is performed on children who have epilepsy which does not respond to medical interventions, and whose epilepsy arises from only one region or hemisphere. Epilepsy is condition or disorder in the brain which results in the occurrence of seizures. During the procedure the band of nerves is cut, thus severing the connection between the hemispheres.

Patients who need functional hemispherectomy will have to go through a long course of pre-surgery procedures. These procedure include electroencephalography (EEG), magnetic resonance imaging (MRI), and seizure monitoring. These usually help the doctors see and confirm the area that needs attention.

Functional Hemispherectomy Procedure

The functional hemispherectomy procedure generally starts with inducing the patient to sleep. Then the surgeon opens the scalp and removes a certain portion of the skull, to be able to pull back some sections of the membrane that covers the brain. This enables the surgeon to enter the skull and use surgical tools to remove the brain tissues. During this procedure, the surgeon will have to rely on surgical microscopes to help him see the brain structures. Once the tissues are removed from the brain, the membrane and the bone are returned in place. The scalp is then closed with staples or stitches.

After the surgery, patients are expected to stay in the hospital to be monitored regularly for several days. They usually resume school activities in eight weeks or less.

Risks Involved with the Procedure

Patients who undergo functional hemispherectomy may experience bleeding, allergic reactions to anesthesia and infections. There can also be loss of sensation in one side of the body. Other risks include damage to the functional side of the brain, swelling of the brain and vision loss. Some minor problems which may arise include puffy eyes, depression, exhaustion, headaches, nausea and scalp numbness. If the patient experiences any one of these, it is often important to be checked by the doctor.

Results of Functional Hemispherectomy

Some patients may continue to take medications, but their doses are often reduced until they are eventually stopped. Many patients, approximately 60%, who underwent this surgical procedure became seizure-free afterwards.


WebMD: Epilepsy and Functional Hemispherectomy

Epilepsy.com: Hemispherectomy