Complications Related to Delayed Hemorrhage After Hemispherectomy

Abstract

H EMISPHERECTOMY to re l ieve epilepsy and behavioral disturbance in patients with infantile hemiplegia has been an accepted procedure for over 20 years. Although techniques have differed in detail, 5,9,~1,1~,1. the end-point of the operation is the virtual emptying of one half of the cranium. Early postoperative complications such as obstructive hydrocephalus and herniation of the remaining hemisphere have been fully described, 2,~~ but the long-term fate of the large hemicranial deadspace and the remaining hemisphere is mostly unknown. In 1966, Oppenheimer and Griffith ~5 reported a syndrome of delayed hemorrhage into the intracranial cavity characterized by the following sequence of events: