Total Left Cerebral Hemispherectomy for Malignant Glioma

Abstract

The patient had 2 craniotomies with focal removal of the tumor in each case with recurrence. The 3rd operative procedure was total left hemi-spherectomy with the included malignant tumor mass. This operation was attended previously with a rather high mortality when done in the right hemisphere. It was also attended with rather severe neurological deficits. This patient has survived 27 months with no evidence of recurrence of the malignant brain tumor and his neurological deficit includes a spastic hemi-paresis on the right, and moderate aphasia. These deficits are gradually decreasing with time, his speech improving and his general condition excellent. It is therefore suggested that there may be certain selected cases in which such a radical procedure as a total hemispherectomy may be indicated. The article does not suggest that all patients with malignant gliomas be subjected to this radical surgery, but rather only those in which the lesion appears to be confined to one cerebral hemisphere.