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Hopkins researchers find postoperative fevers common following hemispherectomy

There is reassuring news for families and medical staff who care for children who spike fevers following hemispherectomy, a surgery in which half the brain is removed to relieve frequent severe seizures that medications cannot control.

Researchers from the Johns Hopkins Children's Center report in the November issue of Pediatric Neurosurgery that these postoperative fevers are usually harmless. As a result, most of these children can probably be spared painful spinal taps or other invasive treatments.

In one of the largest studies of its kind, Hopkins researchers reviewed the charts from 106 consecutive hemispherectomies performed at the Children's Center from January 1975 to December 2001. The review included 102 hemidecortications, a less radical form of hemispherectomy that removes the overlaying gray matter of the brain, preserving the white matter around the ventricle. Medical records were examined for information regarding immediate postoperative problems and care.

Researchers found that few postoperative fevers were caused by serious postoperative complications, such as bacterial meningitis, which is commonly diagnosed by a spinal tap.

"As hemispherectomies become increasingly used in the treatment of unilateral and severe childhood epilepsy, it's important to study and understand the incidence of complications such as meningitis, and other issues in the immediate postoperative period so that we can provide the highest quality care," said lead researcher Eric Kossoff, M.D., a pediatric neurologist at the Children's Center.

The surgery, which leaves intact the deep structures of the brain (the thalamus, brain stem and basal ganglia) is performed at Hopkins on children with Rasmussen's syndrome, a variety of developmental abnormalities on one side of the brain, and on those who have had disabling strokes. First attempted by Johns Hopkins surgeon Walter Dandy, M.D. in the late 1920s, the operation was reintroduced
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Contact: Jessica Collins
jcolli31@jhmi.edu
410-516-4570
Johns Hopkins Medical Institutions
8-Nov-2002


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