{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T10:18:52Z","timestamp":1778494732349,"version":"3.51.4"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of the Child Neurology Society"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hemispherectomy and hemispherotomy represent well\u2010established treatments for drug\u2010resistant hemispheric epilepsy. An alternative endovascular procedure has been explored for cases with challenging surgical anatomy, which seeks to achieve the clinical effect of hemispherectomy via embolization of the major cerebral arteries and subsequent hemispheric infarction. Neither the safety nor effectiveness of this procedure has been established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient Description<\/jats:title><jats:p>A 4\u2010month\u2010old girl with a history of drug\u2010resistant focal epilepsy due to left\u2010sided hemimegalecephaly previously treated with endovascular hemispherectomy at another institution presented for surgical evaluation due to ongoing electroclinical seizures despite multiple antiseizure medications. Pre\u2010operative magnetic resonance imaging (MRI) revealed viable tissue, including mesial temporal structures, and a salvage hemispherotomy was performed. The embolized cortex was surprisingly well\u2010perfused intra\u2010operatively. Postoperatively, she has had no further seizures at 1\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Embolization of the three large hemispheric arteries achieved neither complete hemispheric destruction nor complete disconnection in this case and did not resolve the patient's seizures, necessitating salvage hemispherotomy. While it is difficult to draw definitive conclusions from a single patient's course, our experience suggests that endovascular hemispheric destruction may not be an effective substitute for surgical hemispherectomy or hemispherotomy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cns3.70003","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T06:24:32Z","timestamp":1742365472000},"page":"110-114","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Salvage Trans\u2010Sylvian Peri\u2010Insular Hemispherotomy After Embolic Hemispherectomy"],"prefix":"10.1002","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7166-0616","authenticated-orcid":false,"given":"Michael E.","family":"Baumgartner","sequence":"first","affiliation":[{"name":"The Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudha","family":"Kessler","sequence":"additional","affiliation":[{"name":"Division of Neurology The Children's Hospital of Philadelphia Philadelphia Pennsylvania USA"},{"name":"Department of Neurology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Galligan","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery The Children's Hospital of Philadelphia Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James E.","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery College of Medicine, University of Central Florida Orlando Florida USA"},{"name":"AdventHealth for Children Orlando Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin C.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery The Children's Hospital of Philadelphia Philadelphia Pennsylvania USA"},{"name":"Department of Neurosurgery University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bas.2023.101766"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2009.09.006"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3171\/ped.2004.100.2.0125"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-006-0149-9"},{"issue":"5","key":"e_1_2_7_6_1","first-page":"1076","article-title":"Hemimegalencephaly and Intractable Epilepsy Treated With Embolic Hemispherectomy","volume":"16","author":"Mathis J. 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