The Corpus Callosotomy Procedure

I myself have never undergone a major surgical procedure. The only time I’ve ever been under anesthesia was to have my wisdom teeth out. Since the only knowledge I had of surgical operations was from what I had seen on the almost certainly inaccurate show Grey’s Anatomy, I decided to look into how the corpus callosotomy, an incredibly serious surgery, is actually carried out. The Children’s Hospital of Pittsburgh website offered me the information I was looking for.

 

The basic idea of the surgery is that the corpus callosum, the space between the two halves of the brain, will be severed. The degree to which it is severed depends on the individual procedure and the severity of the epilepsy being treated. In order to start the process, the top section of the patient’s head will be shaved in order to clear an open space for operating. At this point, the patient is put under general anesthesia.

 

The operation begins with an incision at the top of the head, and a piece of the skull is removed to give the surgeon access to the patient’s brain. This part is called a craniotomy, and it is a part of many invasive brain surgeries. Once the surgeon has access to the brain, they use microsurgical techniques to enter directly between the two halves of the brain. First, the anterior two-thirds of the corpus callosum is severed. In some cases, this is where the procedure would stop, and it would be classified as a partial callosotomy, as only the front section of the corpus callosum is cut. If the patient is to undergo a complete callosotomy, the surgeon will then also sever the posterior third of the corpus callosum. Often, this step is carried out in a later surgery. At this point, the two halves of the brain are not connected by anything. After this is complete, the surgeon covers the exposed brain with the dura, which is the brain’s outer membrane, and and the piece of skull that was removed is put back in place. The surgical site is then sealed with absorbable sutures in the scalp.

 

Following the operation, the patient is placed in the Intensive Care Unit (ICU), and they are closely observed for any changes in blood pressure, breathing, or heartbeat. About a week of hospitalization is common after the surgery, and months of rehabilitation is typical to ensure proper brain functioning, and the patient will be watched to see if the surgery eliminated their epileptic condition. Often, the doctors will perform a partial callosotomy first, and then if the patient is still suffering from seizures, the complete callosotomy is performed. Some possible complications of the procedure are the loss of speech, weak limbs, and lack of bladder control. There can also be bleeding, swelling, or infection at the surgical site, but most complications that arise are corrected after a couple weeks.

 

Children’s Hospital of Pittsburgh. “Corpus Callosotomy.” Children’s Hospital of Pittsburgh, UPMC, 2017, www.chp.edu/our-services/brain/neurosurgery/epilepsy-surgery/services/corpus-callosotomy#sthash.fxMp5FD0.dpuf.