June 7, 2001
MEDIA CONTACT: Wendy Mullins
June 5, 2001, Johns Hopkins Children’s Center pediatric neurosurgeon Anthony Avellino, M.D., performed the 100th hemispherectomy at Johns Hopkins, an operation in which half of the brain is removed to relieve severe seizure disorders medications can not control. The day after the operation, the 18-month-old patient Ben Drilling, from New Orleans, was up and eating.
In a hemispherectomy, the deep structures of the brain (the thalamus, brain stem and basal ganglia) are left intact. Hopkins neurologists and neurosurgeons suggest the surgery for children with Rasmussen’s syndrome and developmental abnormalities on one side of the brain, or those who have had severe disabling strokes. It is considered only when drugs cannot control the seizures, and the patient is increasingly handicapped by them.
First attempted by Johns Hopkins surgeon Walter Dandy, M.D., in the late 1920s, the operation was reintroduced at Hopkins 1968, and refined in the mid-1980s by Director of Pediatric Neurosurgery Benjamin S. Carson, M.D., who has since performed more than 85.
Patients with hemispherectomies always have some paralysis on the side of the body opposite the removed hemisphere. Surgery does not appear to decrease a child’s intellect. Intelligence sometimes, in fact, improves due in part to a lack of seizures and elimination of anti-seizure medications. When there are no complications, many of these children leave the hospital for rehabilitation within two weeks of surgery.
A former neurosurgery fellow at the University of Washington School of Medicine, Avellino joined the Division of Pediatric Neurosurgery in January 2001. A specialist in the treatment and management of spine and acute head injuries, he is pursuing research in the field of brain and spinal cord nerve regeneration.