Modification of peri-insular hemispherotomy and surgical results

OBJECTIVE: We modified the peri-insular hemispherotomy technique devised by Villemure and Mascott. Our modified technique and the surgical results obtained with this method are presented. METHODS: The frontoparietal operculum is resected, and the resection cavity is connected with the lateral ventricle. Through this cavity, a transventricular corpus callosotomy and resection of the medial temporal structures are performed. RESULTS: This technique was used for 34 patients, with satisfactory surgical results. Cerebrospinal fluid shunt placement was necessary for five patients, and incomplete callosal sectioning was postoperatively detected in three cases. CONCLUSION: Our modification of the peri-insular hemispherotomy can be safely and effectively used to treat epilepsy caused by hemispheric lesions, even in cases without ventricular dilation.