Extraventricular corpus callosotomy

Abstract

Corpus callosotomy offers useful palliation for selected patients with medically intractable seizures, particularly those with uncontrolled and disabling drop attacks. Here the authors present their technique for performing a corpus callosotomy that allows for complete sectioning of the callosum while avoiding entry into the lateral ventricles. The anatomical basis for the technique is the presence of a definable cleft just ventral to the corpus callosum in the midline, formed by the fusion of the two laminae of the septum pellucidum. This small cleft is typically present even in the absence of a cavum septum pellucidum on MR imaging. The authors have found that dividing the body of the corpus callosum by exploiting the cleft of the septum pellucidum in the absolute midline is a simple and expeditious way to perform a callosotomy without entering the lateral ventricles.