BACKGROUND: In @entity1 with medically intractable @entity302 and diffuse unilateral hemispheric disease, functional or disconnective hemispherectomy is a widely accepted and successful treatment option. If recurrent @entity410 develop after disconnective hemispherectomy, management options become more complex and include conversion to anatomic hemispherectomy. OBJECTIVE: To present the outcomes of all @entity1 undergoing reoperative hemispherectomy in 1 institution by 1 surgeon since 1998. METHODS: The medical records, operative reports, and imaging studies for 36 @entity1 undergoing reoperative hemispherectomy for continuing medically intractable @entity302 from 1998 to 2011 at Cleveland Clinic were reviewed. @entity1 characteristics, cause of @entity410 , imaging findings, surgery-related complications, and long-term @entity410 outcomes were evaluated. RESULTS: @entity1 presented with a variety of @entity410 origins, including @entity198 , perinatal @entity1188 , @entity6795 , and @entity6788 . Overall, 19% of @entity1 were @entity410 free after conversion to anatomic hemispherectomy, and 45% reported a decrease in @entity410 frequency by >=    90%. An additional 36% reported no improvement. Generalized ictal electroencephalography tended to confer a poorer prognosis, as did @entity6795 as the underlying diagnosis. CONCLUSION: The possibility that residual epileptogenic tissue in the operated hemisphere remains connected should be considered after failed functional hemispherectomy because our data suggest that improvement in @entity410 frequency is possible after reoperative hemispherectomy, although the chance of obtaining @entity410 freedom is relatively low. The decision to proceed with reoperative hemispherectomy should be made after proper discussion with the @entity1 and family and informed consent is given.

Reoperative hemispherectomy for intractable XXXX : a report of 36 @entity1 .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'Patient'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizure', 'seizures'] @entity198 :: ('MESH:D004660', 'Disease') :: ['Rasmussen encephalitis'] @entity6795 :: ('MESH:D054220', 'Disease') :: ['cortical dysplasia'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['infarction'] @entity302 :: ('MESH:D004827', 'Disease') :: ['epilepsy'] @entity6788 :: ('MESH:D065705', 'Disease') :: ['hemimegalencephaly']
@entity302 :: (MESH:D004827,Disease) :: ['epilepsy']
