Hemispherectomy and diaschisis : rapid improvement in cerebral functions after right hemispherectomy in a six year old child. Arch Clin Neuropsych

Neuroradiological, neurological, and neuropsychological studies before and af-ter hernrspherectorny for seizures of a SIS year old boy with left herniplegra t birth revealed strrkrng postoperative improvement. Seizures ceased and have not recurred. Preoperative EEG studres from seven months of age revealed mcreas-ing pathological mvolvement of the left as well as right hemisphere. Postopera-tively, normal tracings over the left hemrsphere documented marked and contrn-umg rmprovernent. In contrast to marked1.v subnormal preoperative U’ISC-R IQs. retest at 19 months postoperatrvely showed U’ISC-R IQs within the normal range, wrth sunrlar rrnprovernent mother tests of cognrtlve, motor and sensory functrons. The arrest and reversal of the preoperatrve pattern of mcreasing deterroratron and drsappearance of pathologrcal mvolvernent of left as well as rrght hemrsphere functions followrng surgery is consistent wrth the disappear-ante of draschrsrs as described by van Monakow m 1914, and has concervabl) s/gnif/cant clinrcal as well as theoretrcal rmplicatlons Until the development of hemispherectomy for glioma in adults by Dan-dy in 1928 and for intractable seizures in children by Krynauw in 1950, the established concepts of differences in the functions of the two cerebra