TY - JOUR
T1 - The interhemispheric approach in children
T2 - our experience and review of the literature
AU - Soleman, Jehuda
AU - Ber, Roee
AU - Constantini, Shlomi
AU - Roth, Jonathan
N1 - Publisher Copyright:
© 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2019/3/4
Y1 - 2019/3/4
N2 - Objective: The interhemispheric approach (IA) has been extensively described for treating pathologies located at the lateral or third ventricle, pineal region, and periventricular locations. While these anatomical locations are the target of many pediatric pathologies, very few series have analyzed the morbidity and outcome of the IA in children. The aim of this study is to describe our experience using the IA in children, emphasizing the approach-related morbidity. Methods: Twenty-six patients underwent 28 procedures using the IA between the years 2012 and 2016. Data for these patients was retrospectively analyzed. Surgical and approach-related morbidity were collected and analyzed. Results: The mean age of the cohort was 10.1 ± 4.2 years and included 15 females (57.7%). Approach-related morbidity occurred following eight surgeries (28.6%; seven with anterior IA and one with posterior IA), including two pseudomeningoceles (7.1%), three persistent subdural effusions (10.7%), of which two were locally drained and one required subduro-peritoneal shunting, one epidural bleed (3.6%) which resolved spontaneously, and two infections (3.6%) treated with antibiotics. Cerebrospinal fluid leaks, supplementary motor area syndrome, seizures, and subdural hematomas did not occur in any of the patients. None of the approach-related complications led to permanent morbidity or to mortality. Conclusion: The IA for lesions in and around the ventricular system is feasible and associated with a low permanent complication rate. When choosing this approach, the morbidity, although rarely permanent, should be considered.
AB - Objective: The interhemispheric approach (IA) has been extensively described for treating pathologies located at the lateral or third ventricle, pineal region, and periventricular locations. While these anatomical locations are the target of many pediatric pathologies, very few series have analyzed the morbidity and outcome of the IA in children. The aim of this study is to describe our experience using the IA in children, emphasizing the approach-related morbidity. Methods: Twenty-six patients underwent 28 procedures using the IA between the years 2012 and 2016. Data for these patients was retrospectively analyzed. Surgical and approach-related morbidity were collected and analyzed. Results: The mean age of the cohort was 10.1 ± 4.2 years and included 15 females (57.7%). Approach-related morbidity occurred following eight surgeries (28.6%; seven with anterior IA and one with posterior IA), including two pseudomeningoceles (7.1%), three persistent subdural effusions (10.7%), of which two were locally drained and one required subduro-peritoneal shunting, one epidural bleed (3.6%) which resolved spontaneously, and two infections (3.6%) treated with antibiotics. Cerebrospinal fluid leaks, supplementary motor area syndrome, seizures, and subdural hematomas did not occur in any of the patients. None of the approach-related complications led to permanent morbidity or to mortality. Conclusion: The IA for lesions in and around the ventricular system is feasible and associated with a low permanent complication rate. When choosing this approach, the morbidity, although rarely permanent, should be considered.
KW - Interhemispheric
KW - Morbidity
KW - Pediatric neurosurgery
KW - Surgical approach
KW - Ventricular lesions
UR - http://www.scopus.com/inward/record.url?scp=85059606210&partnerID=8YFLogxK
U2 - 10.1007/s00381-018-04039-2
DO - 10.1007/s00381-018-04039-2
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C2 - 30617576
AN - SCOPUS:85059606210
SN - 0256-7040
VL - 35
SP - 445
EP - 452
JO - Child's Nervous System
JF - Child's Nervous System
IS - 3
ER -