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The interhemispheric approach in children: our experience and review of the literature

  • Jehuda SolemanEmail author
  • Roee Ber
  • Shlomi Constantini
  • Jonathan Roth
Original Article
  • 27 Downloads

Abstract

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.

Keywords

Interhemispheric Surgical approach Pediatric neurosurgery Ventricular lesions Morbidity 

Notes

Acknowledgments

We would like to thank Mrs. Adina Sherer for the medical proof reading of this manuscript, and Danil A. Kozyrev MD for providing us with the photographic material.

Compliance with ethical standards

Conflict of interest

The authors have no disclosures or conflict of interest.

References

  1. 1.
    Davidson L, Krieger MD, McComb JG (2011) Posterior interhemispheric retrocallosal approach to pineal region and posterior fossa lesions in a pediatric population. J Neurosurg Pediatr 7:527–533CrossRefGoogle Scholar
  2. 2.
    Milligan BD, Meyer FB (2010) Morbidity of transcallosal and transcortical approaches to lesions in and around the lateral and third ventricles: a single-institution experience. Neurosurgery 67:1483–1496 discussion 1496CrossRefGoogle Scholar
  3. 3.
    Patel P, Cohen-Gadol AA, Boop F, Klimo P (2014) Technical strategies for the transcallosal transforaminal approach to third ventricle tumors: expanding the operative corridor. J Neurosurg Pediatr 14:365–371CrossRefGoogle Scholar
  4. 4.
    Shapiro S, Rodgers R, Shah M, Fulkerson D, Campbell RL (2009) Interhemispheric transcallosal subchoroidal fornix-sparing craniotomy for total resection of colloid cysts of the third ventricle. J Neurosurg 110:112–115CrossRefGoogle Scholar
  5. 5.
    Aryan HE, Ozgur BM, Jandial R, Levy ML (2006) Complications of interhemispheric transcallosal approach in children: review of 15 years experience. Clin Neurol Neurosurg 108:790–793CrossRefGoogle Scholar
  6. 6.
    Chi JH, Lawton MT (2006) Posterior interhemispheric approach: surgical technique, application to vascular lesions, and benefits of gravity retraction. Neurosurgery 59:ONS41–ONS49 discussion ONS41–49CrossRefGoogle Scholar
  7. 7.
    D'Angelo VA, Galarza M, Catapano D, Monte V, Bisceglia M, Carosi I (2008) Lateral ventricle tumors: surgical strategies according to tumor origin and development--a series of 72 cases. Neurosurgery 62:1066–1075CrossRefGoogle Scholar
  8. 8.
    Hernesniemi J, Romani R, Dashti R, Albayrak BS, Savolainen S, Ramsey C, Karatas A, Lehto H, Navratil O, Niemelä M (2008) Microsurgical treatment of third ventricular colloid cysts by interhemispheric far lateral transcallosal approach--experience of 134 patients. Surg Neurol 69:447–453 discussion 453-446CrossRefGoogle Scholar
  9. 9.
    Mazza M, Di Rienzo A, Costagliola C, Roncone R, Casacchia M, Ricci A, Galzio RJ (2004) The interhemispheric transcallosal-transversal approach to the lesions of the anterior and middle third ventricle: surgical validity and neuropsychological evaluation of the outcome. Brain Cogn 55:525–534CrossRefGoogle Scholar
  10. 10.
    Peltier J, Roussel M, Gerard Y, Lassonde M, Deramond H, Le Gars D, Gars DL, De Beaumont L, Beaumont LD, Godefroy O (2012) Functional consequences of a section of the anterior part of the body of the corpus callosum: evidence from an interhemispheric transcallosal approach. J Neurol 259:1860–1867CrossRefGoogle Scholar
  11. 11.
    Kanno T, Kasama A, Shoda M, Yamaguchi C, Kato Y (1989) A pitfall in the interhemispheric translamina terminalis approach for the removal of a craniopharyngioma. Significance of preserving draining veins. Part I. clinical study. Surg Neurol 32:111–115CrossRefGoogle Scholar
  12. 12.
    Kubota M, Saeki N, Yamaura A, Ono J, Ozawa Y (2001) Influences of venous involvement on postoperative brain damage following the anterior interhemispheric approach. Acta Neurochir 143:321–325 discussion 325-326CrossRefGoogle Scholar
  13. 13.
    Tsutsumi K, Shiokawa Y, Sakai T, Aoki N, Kubota M, Saito I (1991) Venous infarction following the interhemispheric approach in patients with acute subarachnoid hemorrhage. J Neurosurg 74:715–719CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Departments of Neurosurgery and Pediatric Neurosurgery, Tel-Aviv Sourasky Medical Center and Dana Children’s Hospital Tel AvivTel Aviv UniversityTel AvivIsrael
  2. 2.Department of Neurosurgery, Division of Pediatric NeurosurgeryUniversity Hospital and Children’s Hospital of BaselBaselSwitzerland

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