Corpus Callosotomy (CC), sometimes called split-brain surgery, is a surgical procedure to control generalized seizures in children, primarily atonic seizures (drop attacks), by cutting the corpus callosum. Corpus Callosum refers to a band of nerve fibres located deep in the brain that connects the two hemispheres of the brain. Corpus Callosum is responsible for the transmission of information between the two lobes but it also contributes to transmission of seizure impulses from one lobe to the other. This Surgery however does not completely eliminate seizures, but it prevents them from affecting the entire brain and muscles on both sides of the body. After corpus callosotomy surgery, the seizure may affect muscles on one side of the body, but maintaining muscle tone on the other side, reducing the risk of injury from falls. The surgery is usually performed on children and younger patients.
The surgery is performed under general anaesthesia. Below mentioned are the two methods in which this surgery is performed:
Conventional Method: In this method a small incision is made at the scalp at the top of the head, and this section of the skull is removed. The neurosurgeon then separates the two hemispheres. The surgeon uses special instruments and surgical microscopes to disconnect the corpus callosum or to cut a part of it. The section of skull removed at the start of the procedure is then replaced and fixed in position, and the skin incision is closed.
Laser Ablation Method: In this method, two or three small holes are made and laser surgery is done with help of MRI imaging as a guide. The heat from the precisely focused laser beam cuts the corpus callosum. The precision ensures that the nearby brain tissue is not affected.
In some cases, corpus callosotomy is done in two stages, leaving some of the connections uncut to allow the two hemispheres to share some information. If seizures persist, a second procedure can be done to cut the rest.
The patient is monitored closely for the first 24 hours at the ICU. The usual stay at the hospital lasts for 2-7 days. In case if laser ablation the stay is shorter and the patient is discharged after two days if there are no signs of any complications. The patient can resume normal activity in 4-6 weeks. The hair grows back at the saved area and covers the scar. The patient is also required to continue their anti-seizure medications.
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