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Key anatomical structures that are disconnected include the 1) internal capsule and corona radiata, 2) mesial temporal structures, 3) insula, 4) corpus callosum, 5) parietooccipital connection, and 6) frontobasal connection. A stepwise approach is indicated to ensure adequate disconnection and prevent seizure persistence or recurrence. In young pediatric patients, careful patient selection and modern surgical techniques have resulted in &gt; 80% seizure freedom and very good functional outcome. In this report, the authors summarize the history of hemispherectomy and its development and present a graphical guide for this anatomically challenging procedure. The use of the osteoplastic flap to improve outcome and the management of hydrocephalus are discussed.<\/jats:p>","DOI":"10.3171\/2020.1.focus19889","type":"journal-article","created":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T19:35:29Z","timestamp":1585942529000},"page":"E9","source":"Crossref","is-referenced-by-count":25,"title":["Pediatric functional hemispherectomy: operative techniques and complication avoidance"],"prefix":"10.3171","volume":"48","author":[{"given":"Christopher C.","family":"Young","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah H.","family":"Feroze","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"McGrath","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali C.","family":"Ravanpay","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington;"},{"name":"Department of Neurological Surgery, VA Puget Sound Healthcare System, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G.","family":"Ellenbogen","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington;"},{"name":"Department of Neurological Surgery, Seattle Children\u2019s Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey G.","family":"Ojemann","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington;"},{"name":"Department of Neurological Surgery, Seattle Children\u2019s Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason S.","family":"Hauptman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington;"},{"name":"Department of Neurological Surgery, Seattle Children\u2019s Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1016\/j.wneu.2012.03.020","article-title":"Anatomic hemispherectomy: historical perspective","volume":"80","author":"Bahuleyan B","year":"2013","unstructured":"Bahuleyan B, Robinson S, Nair AR, Sivanandapanicker JL, Cohen AR: Anatomic hemispherectomy: historical perspective. 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