{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:56:14Z","timestamp":1786125374926,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T00:00:00Z","timestamp":1574726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>When the epileptogenic foci skip the motor area, the epilepsy can be cured by surgery while preserving the motor function. This surgery has been reported as subtotal hemispherectomy. The disconnective variant of this surgery, subtotal hemispherotomy, is described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To demonstrate each step clearly, a cadaveric brain, 3-dimensional reconstruction and simulation model, and intraoperative photographs were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A formalin-fixed cadaveric brain was dissected to show each step of this surgery. For the 3-dimensional model, several brain structures were reconstructed from preoperative images, and the surgery was simulated. Intraoperative photographs and postoperative magnetic resonance images were taken from the representative cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Temporo-parieto-occipital disconnection is performed to disconnect these lobes and the insula, limbic system, and splenium of the corpus callosum. The postcentral sulcus is the anterior border of the disconnection. Next, prefrontal disconnection is performed to disconnect the frontal lobe and the insula, frontal lobe and basal ganglia, and the anterior part of the corpus callosum. The precentral sulcus is the posterior border of the disconnection. Finally, corpus callosotomy of the central part is performed. After these steps, subtotal hemispherotomy, with preservation of the pre- and postcentral gyrus, is achieved. The 3-dimensional model clearly shows the anatomic relationships between deep brain structures. In the representative cases, postoperative motor deterioration was transient or none, and seizure-free status was achieved after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Subtotal hemispherotomy is generally difficult because of the complicated anatomy and narrow and deep surgical corridors. Combined use of these methods facilitates a clearer understanding of this surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opz354","type":"journal-article","created":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T03:50:55Z","timestamp":1574740255000},"page":"E209-E218","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Anatomic Understanding of Subtotal Hemispherotomy Using Cadaveric Brain, 3-Dimensional Simulation Models, and Intraoperative Photographs"],"prefix":"10.1227","volume":"18","author":[{"given":"Takehiro","family":"Uda","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan"},{"name":"Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noritsugu","family":"Kunihiro","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saya","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Nakajo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Tanoue","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Uda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoko","family":"Umaba","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Kuki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"Kawawaki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Ohata","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,6]]},"reference":[{"issue":"7","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/j.clinph.2017.03.031","article-title":"Epileptogenic high-frequency oscillations skip the motor area in children with multilobar drug-resistant epilepsy","volume":"128","author":"Iimura","year":"2017","journal-title":"Clin Neurophysiol"},{"issue":"12","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1111\/epi.12845","article-title":"\u201cSubtotal\u201d hemispherectomy in children with intractable focal epilepsy","volume":"55","author":"Chugani","year":"2014","journal-title":"Epilepsia"},{"issue":"8","key":"bib3-20240909","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1111\/j.1528-1167.2007.01095.x","article-title":"Posterior quadrantic epilepsy surgery: technical variants, surgical anatomy, and case series","volume":"48","author":"Daniel","year":"2007","journal-title":"Epilepsia"},{"key":"bib4-20240909","doi-asserted-by":"crossref","first-page":"e792","DOI":"10.1016\/j.wneu.2018.08.168","article-title":"Anatomical understanding of posterior quadrant disconnection from cadaveric brain, 3D reconstruction and simulation model, and intraoperative photographs","volume":"120","author":"Umaba","year":"2018","journal-title":"World Neurosurg"},{"issue":"5","key":"bib5-20240909","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1111\/epi.12547","article-title":"Posterior quadrant disconnection surgery for Sturge-Weber syndrome","volume":"55","author":"Sugano","year":"2014","journal-title":"Epilepsia"},{"issue":"Pt 10","key":"bib6-20240909","doi-asserted-by":"crossref","first-page":"2316","DOI":"10.1093\/brain\/awh246","article-title":"Functional connectivity in the human language system: a cortico-cortical evoked potential study","volume":"127","author":"Matsumoto","year":"2004","journal-title":"Brain"},{"issue":"2","key":"bib7-20240909","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.clinph.2017.11.026","article-title":"Intraoperative cortico-cortical evoked potentials show disconnection of the motor cortex from the epileptogenic network during subtotal hemispherotomy","volume":"129","author":"Inoue","year":"2018","journal-title":"Clin Neurophysiol"},{"issue":"1","key":"bib8-20240909","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/j.1528-1167.2010.02777.x","article-title":"The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission","volume":"52","author":"Blumcke","year":"2011","journal-title":"Epilepsia"},{"issue":"4","key":"bib9-20240909","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1227\/NEU.0000000000001272","article-title":"Anatomic understanding of vertical hemispherotomy with cadaveric brains and intraoperative photographs","volume":"12","author":"Uda","year":"2016","journal-title":"Oper Neurosurg (Hagerstown)"},{"issue":"2","key":"bib10-20240909","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/epi.12010","article-title":"Posthemispherectomy hydrocephalus: results of a comprehensive, multiinstitutional review","volume":"54","author":"Lew","year":"2013","journal-title":"Epilepsia"},{"issue":"2","key":"bib11-20240909","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1017\/S0317167100044668","article-title":"Hemispherectomy for seizures revisited","volume":"10","author":"Rasmussen","year":"1983","journal-title":"Can J Neurol Sci"},{"issue":"12","key":"bib1a-20240909","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1111\/epi.12845","article-title":"\u201cSubtotal\u201d hemispherectomy in children with intractable focal epilepsy","volume":"55","author":"Chugani","year":"2014","journal-title":"Epilepsia"},{"issue":"12","key":"bib2a-20240909","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1111\/epi.13221","article-title":"Surgical treatment for refractory epileptic spasms: The Detroit series","volume":"56","author":"Chugani","year":"2015","journal-title":"Epilepsia"},{"issue":"7","key":"bib3a-20240909","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/j.clinph.2017.03.031","article-title":"Epileptogenic high-frequency oscillations skip the motor area in children with multilobar drug-resistant epilepsy","volume":"128","author":"Iimura","year":"2017","journal-title":"Clin Neurophysiol"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/18\/6\/E209\/33182063\/opz354.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opz354","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:54:37Z","timestamp":1786121677000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opz354"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,26]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opz354","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,26]]},"assertion":[{"value":"2019-04-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-04","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}