Document Detail


The postoperative course and management of 106 hemidecortications.
MedLine Citation:
PMID:  12422044     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE: The excellent long-term outcome for most children undergoing hemispherectomy is well documented. However, the condition of these children in the immediate postoperative period is poorly described. The purpose of this study was to evaluate the short-term issues surrounding hemispherectomy and their management in a series of patients from our institution. METHODS: 106 hemispherectomies were performed at our institution from 1975 to 2001 (102 hemidecortications). Medical records were retrospectively examined for information regarding immediate postoperative problems and care. RESULTS: Three children died in the immediate perioperative period, while 3 others had significant postoperative morbidity. 82% of these children had postoperative fevers (temperature >38.5 degrees C). Of these children, 62% had lumbar punctures. Ten cases had positive CSF growth, of which 6 cases were felt to have actual meningitis. Patients with CSF growth had a significantly longer prior duration of steroid therapy and higher maximum temperature peaks. CSF pleocytosis and an ill clinical appearance neared significance for prediction of CSF growth. Shunting was performed in 19% of all children and was associated with CSF growth. CONCLUSIONS: Postoperative fevers are common after hemidecortication, but meningitis is not. Children with CSF growth tended to appear more ill and have higher temperature spikes and CSF pleocytosis. Shunting was related to CSF growth.
Authors:
E H Kossoff; E P G Vining; P L Pyzik; S Kriegler; K-S Min; B S Carson; A M Avellino; J M Freeman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric neurosurgery     Volume:  37     ISSN:  1016-2291     ISO Abbreviation:  Pediatr Neurosurg     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-07     Completed Date:  2003-03-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9114967     Medline TA:  Pediatr Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  298-303     Citation Subset:  IM    
Copyright Information:
Copyright 2002 S. Karger AG, Basel
Affiliation:
Department of Neurology and Pediatrics, The Pediatric Epilepsy Center, Johns Hopkins Medicla Institutions, Baltimore, Md, USA. ekossoff@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-Inflammatory Agents / administration & dosage
Bacterial Infections / complications,  diagnosis
Cerebrospinal Fluid / microbiology*
Child
Child, Preschool
Dexamethasone / administration & dosage
Female
Fever / etiology*
Hemispherectomy* / adverse effects,  mortality
Humans
Infant
Male
Meningitis / cerebrospinal fluid,  complications
Postoperative Period
Retrospective Studies
Spinal Puncture
Treatment Outcome
Ventriculoperitoneal Shunt
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 50-02-2/Dexamethasone

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