Featured Research

from universities, journals, and other organizations

Hopkins Researchers Find Postoperative Fevers Common Following Hemispherectomy

Date:
November 11, 2002
Source:
Johns Hopkins Medical Institutions
Summary:
There is reassuring news for families and medical staff who care for children who spike fevers following hemispherectomy, a surgery in which half the brain is removed to relieve frequent severe seizures that medications cannot control.

There is reassuring news for families and medical staff who care for children who spike fevers following hemispherectomy, a surgery in which half the brain is removed to relieve frequent severe seizures that medications cannot control.

Researchers from the Johns Hopkins Children's Center report in the November issue of Pediatric Neurosurgery that these postoperative fevers are usually harmless. As a result, most of these children can probably be spared painful spinal taps or other invasive treatments.

In one of the largest studies of its kind, Hopkins researchers reviewed the charts from 106 consecutive hemispherectomies performed at the Children's Center from January 1975 to December 2001. The review included 102 hemidecortications, a less radical form of hemispherectomy that removes the overlaying gray matter of the brain, preserving the white matter around the ventricle. Medical records were examined for information regarding immediate postoperative problems and care.

Researchers found that few postoperative fevers were caused by serious postoperative complications, such as bacterial meningitis, which is commonly diagnosed by a spinal tap.

"As hemispherectomies become increasingly used in the treatment of unilateral and severe childhood epilepsy, it's important to study and understand the incidence of complications such as meningitis, and other issues in the immediate postoperative period so that we can provide the highest quality care," said lead researcher Eric Kossoff, M.D., a pediatric neurologist at the Children's Center.

The surgery, which leaves intact the deep structures of the brain (the thalamus, brain stem and basal ganglia) is performed at Hopkins on children with Rasmussen's syndrome, a variety of developmental abnormalities on one side of the brain, and on those who have had disabling strokes. First attempted by Johns Hopkins surgeon Walter Dandy, M.D. in the late 1920s, the operation was reintroduced at Hopkins in 1968 and refined in the mid-1980s by Benjamin S. Carson, M.D., director of pediatric neurosurgery and a co-author of this study.

Researchers found that more than 80 percent of patients had postoperative fevers. Of the patients with fever, 62 percent were given lumbar punctures, or spinal taps, to diagnose suspected bacterial meningitis. Only six of these patients were diagnosed with meningitis, and these children had also complained of headache, lethargy and wound discharge, which the majority of children with low-grade fever alone did not experience.

"This study has already been helpful to the physicians and nurses providing postoperative care for these children because it helps them anticipate which patients truly require spinal taps," said Kossoff. "A child with a low-grade fever who is active and does not exhibit other symptoms is unlikely to be infected, while a child with a high fever, headache, lethargy and actually appears ill is at perhaps higher risk."

Other factors that indicated infections included elevated white blood cell counts in the cerebrospinal fluid (CSF), very high temperatures, and prolonged use of steroids, commonly used in these patients.

As a result of this study, Children's Center doctors and nurses may allow fevers without other symptoms to persist for as long as two weeks if the child is active and playful. Of the 10 patients undergoing hemispherectomy since 2001, only one has required the insertion of a shunt to drain CSF, and none have been diagnosed with bacterial meningitis.

Researchers from the Department of Neurology and Pediatrics, Department of Pediatric Neurosurgery, and the Pediatric Epilepsy Center also contributed to this report. The study was supported in part by funds from the Roxanne Fellowship.


Story Source:

The above story is based on materials provided by Johns Hopkins Medical Institutions. Note: Materials may be edited for content and length.


Cite This Page:

Johns Hopkins Medical Institutions. "Hopkins Researchers Find Postoperative Fevers Common Following Hemispherectomy." ScienceDaily. ScienceDaily, 11 November 2002. <www.sciencedaily.com/releases/2002/11/021111070718.htm>.
Johns Hopkins Medical Institutions. (2002, November 11). Hopkins Researchers Find Postoperative Fevers Common Following Hemispherectomy. ScienceDaily. Retrieved July 25, 2014 from www.sciencedaily.com/releases/2002/11/021111070718.htm
Johns Hopkins Medical Institutions. "Hopkins Researchers Find Postoperative Fevers Common Following Hemispherectomy." ScienceDaily. www.sciencedaily.com/releases/2002/11/021111070718.htm (accessed July 25, 2014).

Share This




More Health & Medicine News

Friday, July 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

AFP (July 24, 2014) A so-called drugs rehab 'clinic' is closed down in Pakistan after police find scores of ‘patients’ chained up alleging serial abuse. Duration 03:05 Video provided by AFP
Powered by NewsLook.com
Too Few Teens Receiving HPV Vaccination, CDC Says

Too Few Teens Receiving HPV Vaccination, CDC Says

Newsy (July 24, 2014) The Centers for Disease Control and Prevention is blaming doctors for the low number of children being vaccinated for HPV. Video provided by Newsy
Powered by NewsLook.com
New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

    Health News

      Environment News

        Technology News



          Save/Print:
          Share:

          Free Subscriptions


          Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

          Get Social & Mobile


          Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

          Have Feedback?


          Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
          Mobile: iPhone Android Web
          Follow: Facebook Twitter Google+
          Subscribe: RSS Feeds Email Newsletters
          Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins