Материалы и методы

neurosurgery

Нейрохирургия

Russian journal of neurosurgery

1683-32952587-7569

Издательский дом "МедИНК"

10.17650/1683-3295-2018-20-1-56-63

neurosurgery-514

Research Article

ОБЗОРЫ ЛИТЕРАТУРЫ

LITERATURE REVIEW

ГЕМИСФЕРЭКТОМИЯ: ПОЧЕМУ МЫ ВСЕ ЕЩЕ ИСПОЛЬЗУЕМ ЭТОТ МЕТОД В ЛЕЧЕНИИ ЭПИЛЕПСИИ? ТЕХНИЧЕСКИЕ ОШИБКИ, РЕЗУЛЬТАТЫ И ОСЛОЖНЕНИЯ

HEMISPHERECTOMY: WHY WE STILL USE IN EPILEPSY TREATMENT? TECHNICAL PITFALLS, RESULTS AND COMPLICATIONS

Пирес ду Агиар

П.Э.

Pires de Aguiar

P.H.

Отделение нейрохирургии

отделение нейрохирургии

последипломное отделение, факультет хирургии

факультет неврологии

отделение нейрохирургии

Division of Neurosurgery

Division of Post-Graduation, Department of Surgery

Department of Neurology

Department of Neurosurgery

phpaneurocir@gmail.com

Кампорезе

Б.

Camporeze

ду Моура Лима

А.

De Moura Lima

отделение нейрохирургии

Department of Neurosurgery

Эстевао

И. А.

Estevão

I.A.

Матрикарди

Д.

Matricardi

факультет неврологии

Department of Neurology

Симис

С.

Simis

факультет неврологии

Department of Neurology

Родригес

Л.

Rodrigues

неврологическое отделение

Division of Neurology

Симм

Р.

Simm

неврологическое отделение

Division of Neurology

Госпиталь Санта Паула; Госпиталь Освальдо Круз; Федеральный университет Риу-Гранди-ду-Сулл; Порту-Алегри; Папский католический университет Сан-Паулу; Госпиталь для государственных служащих Сан-ПаулуБразилияSanta Paula Hospital; Oswaldo Cruz Hospital; Federal University of Rio Grande do Sul; Pontifical Catholic University of São Paulo; Public Servant Hospital of São PauloBrazil

Медицинская школа Университета Святого ФранцискаБразилияMedical School of São Francisco UniversityBrazil

Госпиталь для государственных служащих Сан-ПаулуБразилияPublic Servant Hospital of São PauloBrazil

Папский католический университет Сан-ПаулуБразилияPontifical Catholic University of São PauloBrazil

Госпиталь Санта ПаулаБразилияSanta Paula HospitalBrazil

2018

22042018

2015663

2018

Пирес ду Агиар П., Кампорезе Б., ду Моура Лима А., Эстевао И.А., Матрикарди Д., Симис С., Родригес Л., Симм Р.

Pires de Aguiar P., Camporeze B., de Moura Lima A., Estevão I., Matricardi G., Simis S., Rodrigues L., Simm R.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.therjn.com/jour/article/view/514

Цель исследования – анализ данных литературы о показаниях к применению, особенностях техники, рисках, осложнениях, результатах применения гемисферэктомии в лечении эпилепсии.

Материалы и методы

Материалы и методы. Выполнен библиографический поиск источников за 1920–2016 гг. в базах данных MEDLINE, LILACS, SciELO, PubMed; в качестве ключевых слов использованы «эпилептические приступы», «эпилепсия», «гемисферэктомия»; язык публикации был критерием отбора: отдавалось предпочтение самым последним статьям на португальском, испанском или английском языке, а также отбирались только статьи, которые описывают исследования, проводимые на людях.

Результаты

Результаты. Функциональная гемисферэктомия продемонстрировала улучшение качества жизни и снижение частоты приступов – тонических, атонических или тонико-клонических – у пациентов с фармакорезистентными формами эпилепсии. Кроме того, функциональная гемисферэктомия, по сравнению с анатомической, позволяет снизить уровень послеоперационных осложнений, таких как поверхностный гемосидероз, эпендимит и окклюзионная гидроцефалия.

Выводы

Выводы. Применение функциональной гемисферэктомии в отдельных случаях позволяет улучшить состояние пациентов, страдающих фармакорезистентными формами эпилепсии. Однако мы пришли к выводу, что не существует какого-либо значимого исследования, в котором сравнивались бы результаты функциональной гемисферэктомии в зависимости от патологий, ставших показанием к ее выполнению, и которое в будущем может стать важным источником данных по этой теме.

Objective is to discuss the indications, technical details, risks, complications, results and prognosis of hemispherectomy in the treatment of seizures based on critical literature review and the authors experience.

Materials and methods

Materials and methods. It was performed bibliographical consultation from 1920 to 2016, using as keywords “seizures”, “epilepsy”, “hemispherectomy”, in the databases MEDLINE, LILACS, SciELO, PubMed, utilizing language as selection criteria, choosing preferably recent articles in Portuguese, Spanish or English and only articles based in humans studies.

Results

Results. The functional hemispherectomy showed improvent in the quality of life of patients that has the indication to perform this procedure because it allows reducing the frequency of seizures, whether tonic or atonic, tonic-clonic. Furthermore, it has been associated to a low rates of postoperative complications, like superficial hemosiderosis, ependymitis and obstructive hydrocephalus that often it has been showed in anatomical hemispherectomy.

Conclusion

Conclusion. The functional hemispherectomy has been showed a significant impovement in the outcome for those with seizures arising when indicated to selected cases. However, we concluded that there is no important study comparing the functional hemispherectomy approaches with results adjusted for different causative pathologies, what would be for future necessary for an important source of data about this topic.

нейрохирургияэпилепсияэпилептические приступыполушария головного мозгагемисферэктомия

neurosurgeryepilepsyseizurescerebral hemispherehemispherectomy

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The authors declare that there are no conflicts of interest present.