Case 3: Cerebral Hemispherectomy Flashcards
What is right homonymous hemianopsia
Visual field defect involving the right halves of the visual field of both eyes
What is a VENTRICULOPERITONEAL (VP) SHUNT:
Device used to treat hydrocephalus that allows fluid to move from the ventricle of the brain out
What is the PT POC/goals for Cerebral Hemispherectomy
- prevent loss for ROM and , strength
- maximize physcial function and safety
What is Pressure measured inside the skull, and thus, the pressure exerted on the brain tissue and CSF
Intracranial pressure
What is cortical dysplasia
Congenital malformation of the cortex , a cause of seizures
What is the PT interventions for Cerebral Hemispherectomy
- family education
- positioning ROM exercises to prevent contractures of neck , spine and extremities
- equipment needed for mobility
What are the precautions during PT for Cerebral Hemispherectomy
- delayed hydrocephalus that can develop at any time post sx
- any gradual change —> may indicate VP shunt or shunt revision
- seizures may reoccur due to delayed hydrocephalus
What are the complications interfering with PT for kids with Cerebral Hemispherectomy
- global delays in cognition , language , fine motor , gross motion , social , emotional and adaptive development
- functional skills impacted by visual and/or perceptual neglect
- persistent hemiparesis with more distal extremity invovlment
- spasticity
- sensory impairments
What is a Cerebral Hemispherectomy
Complete surgical resection and/or disconnection of one hemisphere
What is Cerebral Hemispherectomy performed to stop
The detrimental effects of chronic and persistent drug resistant seizures on a child’s development
What developmental examination could be considered with Cerebral Hemispherectomy
Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III)
What does the Bayley III (developmental instrument) assess
- cognition
- language
- motor skills
Ages 1 month to 42 months
To assess gross motor. Development for kids with Cerebral Hemispherectomy, what can PT use
Gross Motor Function Measure-66 (GMFM-66) or the GMFM-88 (which includes 22 more items)
What kind of therapy improves motor function and increased the use of hemiparesis extremity in children with Cerebral Hemispherectomy,
Constraint induced movement therapy
What is the most common indication for a cerebral hemispherectomy? (Question 1)
Medial intractable seizures
What is the typical clinical presentation of children status/post hemispherectomy (question 2)
Global delays in all areas with more involvement in the involved distal upper extremity
How should PT intervention for children statis/post hemispherectomy be? (Question 3)
should be novel, task-specific, intense, and repetitive.
