Functional Hemispherectomy in Children

What Is a Hemispherectomy?

A hemispherectomy is when one side of the brain is surgically disconnected from the rest of the brain so that seizures that originate in that hemisphere have nowhere to go. This procedure is also called “functional hemispherectomy.”

Only children who have severe epilepsy with seizures originating from only one side of the brain are candidates for this surgery. Hemispherectomy surgery is usually only performed when that particular side of the brain is already functioning poorly, either because of injury or because the child was born with conditions that cause excessive damage to the brain, so the patient doesn’t lose additional brain function.

Contact the Epilepsy Surgery Program at UPMC Children's Hospital of Pittsburgh

To make a referral, schedule an appointment, or request an evaluation for a child or teen, contact us at 412-692-6928 or email

What to Expect Before Functional Hemispherectomy Surgery

Children are given a general anesthesia prior to the surgery. To prepare for the surgery, part of your child’s hair will be shaved.

What Happens During Hemispherectomy?

An incision will be made and a craniotomy will be performed (removal of a piece of the skull that will be replaced at the end of the surgery). The surgeon may remove some parts of the brain and disconnect other parts. The corpus callosum will be cut to prevent the spread of seizures to the functional side of the brain.

At the end of the procedure, the skull will be replaced and the scalp will be sutured closed. The surgery takes about six hours.

What to Expect After Hemispherectomy Surgery

Your child will be in the Intensive Care Unit (ICU) overnight or until he or she is medically stable enough to go to another nursing unit. While still in the ICU, your child will be observed continuously and blood pressure, pulse and respiration will be checked frequently.

Once out of the ICU your child will probably require an additional five to seven days of hospitalization. Inpatient or outpatient rehabilitation may be necessary to optimize your child’s recovery. Your child will be evaluated carefully over the next few months to see what effect surgery had on the seizures and whether there are persistent complications.

Potential Complications of Hemispherectomy in Children

Your child may have:

  • Scalp numbness
  • Nausea
  • Fatigue
  • Depression
  • Headache
  • Difficulty with speech and memory
  • Neuropsychological tests will be performed to detect any changes in your child’s function.

    As with any surgery, there is a potential for complications. The major problems that could develop are bleeding and infection. Other risks of this procedure include developmental problems and loss of peripheral vision.

    Weakness on the opposite side from the operation site may occur. But children can function with only half a brain because the remaining side takes over many of the functions of the half that was removed. If the surgery is done early in childhood, the child is more likely to compensate for the loss of one side of the brain.