Post hemispherectomy for Rassmussen encephalitis
Seizures and twitching. PH of hemispherectomy for Rassmussen encephalitis as a child. Long standing right hemiplegia but otherwise functioning normally.
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Absence of the left cerebrum apart from the basal ganglia. Note atrophy of the left cerebral peduncle (arrow) and filling of the left hemicranial space by CSF.
This radical surgery is rarely performed in childhood for developmental lesions (mostly extensive cortical dysplasias), acute pathologies such as MCA infarct or trauma and progressive pathology such as Rasmussen encephalitis and Sturge-Weber syndrome. Despite the almost inevitable development of hemiplegia, most children have an excellent long-term outcome with reduction or absence of seizures, and normal intellectual function and speech.