Role of external ventriculostomy in the management of fever after hemispherectomy

Abstract

Fever is a common occurrence after cerebral hemispherectomy in children and prolongs the hospital stay. The authors determined whether an external ventriculostomy might reduce the incidence of fever following a hemispherectomy. The postoperative courses of 27 patients who had undergone cerebral hemispherectomy for intractable seizures were retrospectively analyzed. Thirteen children underwent an external ventriculostomy, and only 1 had an elevated axillary body temperature of > or = 39 degrees C during the postoperative period. Among 14 patients who did not undergo an external ventriculostomy, 7 had a posthemispherectomy fever of > or = 39 degrees C. Patients who underwent an external ventriculostomy had a lower risk of postoperative fever compared with those who did not undergo the procedure (8 vs 50%, respectively; p = 0.03, Fisher exact test). None of the patients had an infection accounting for the cause of the fever. The hospital stay for patients who had undergone postoperative external ventriculostomy was significantly shorter than for those who had not (7.2 +/- 2 vs 11.3 +/- 5 days, respectively; p = 0.01, Student t-test). The use of external ventriculostomy following hemispherectomy for intractable epilepsy in children reduces the incidence of postoperative fever due to infection.