Evidence map›Paper›PMID 41028505›Full record

Observational studyPediatric research2026

Transarterial embolization versus hemispherectomy in infants with hemimegalencephaly and drug-resistant epilepsy.

Shani Israel, Nora Wolff, Lindsay Ruffini, Georgios Sanidas, Courtney R Lowe, Thevaasiinen Chandereng, Madison M Berl, Tammy N Tsuchida, Tayyba Anwar, Monica S Pearl and 6 more

Abstract readObservational StudyComparative Study
PubMed Publisher
In one paragraph

Observational study in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Shani IsraelChildren's National Hospital, Washington, DC, USA.
Nora WolffChildren's National Hospital, Washington, DC, USA.
Lindsay RuffiniChildren's National Hospital, Washington, DC, USA.
Georgios SanidasChildren's National Hospital, Washington, DC, USA.
Courtney R LoweChildren's National Hospital, Washington, DC, USA.
Thevaasiinen ChanderengChildren's National Hospital, Washington, DC, USA.
Madison M BerlChildren's National Hospital, Washington, DC, USA.
Tammy N TsuchidaChildren's National Hospital, Washington, DC, USA.
Tayyba AnwarChildren's National Hospital, Washington, DC, USA.
Monica S PearlChildren's National Hospital, Washington, DC, USA.
Taeun ChangChildren's National Hospital, Washington, DC, USA.
Chima OluigboChildren's National Hospital, Washington, DC, USA.
Hannah KinneyBoston Children's Hospital, Boston, MA, USA.
Sudeepta BasuChildren's National Hospital, Washington, DC, USA.
Vittorio GalloSeattle Children's Research Institute, Seattle, WA, USA.
Panagiotis KratimenosChildren's National Hospital, Washington, DC, USA. panagiotis.kratimenos@childrensnational.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHemimegalencephaly is a severe congenital brain malformation characterized by early-onset, medically refractory seizures. The standard treatment, surgical hemipherectomy (SH), is constrained by age-related limitations. To address this gap, we developed a staged transarterial embolization (TAE) approach as a minimally invasive alternative for infants under 10-12 weeks. The comparative efficacy of TAE versus SH has not been systematically evaluated.

methodsThis single-center observational comparative effectiveness study evaluated seizure burden, neurodevelopmental outcomes, and perioperative hemodynamic stability in infants with hemimegalencephaly treated with TAE (n = 12) versus SH (n = 11). Hemodynamic metrics (blood pressure, fluid balance, serum metabolites) were analyzed using linear mixed models.

resultsSix of eight (75%) patients receiving TAE as the primary treatment achieved seizure freedom. Neurodevelopmental outcomes in the TAE cohort were comparable to those in the SH cohort. Hemodynamic stability in the TAE group was supported by smooth transitions in blood transfusions and fluid administration, avoiding abrupt fluctuations and enabling blood pressure control equivalent to SH. Both cohorts maintained tight regulation of serum sodium, glucose, and potassium.

conclusionTAE provides hemodynamically stable seizure control in infants with hemimegalencephaly, minimizing cerebral edema and preserving contralateral perfusion. These findings position TAE as a feasible early alternative to SH for hemimegalencephaly. IMPACT: Transarterial embolization (TAE) enables early seizure cessation in infants with hemimegalencephaly under 10-12 weeks of age, providing a novel therapeutic option for patients ineligible for surgical hemispherectomy. Infants treated with TAE maintain hemodynamic stability, supporting preserved perfusion in the contralateral hemisphere. This study establishes TAE as an effective early intervention that broadens the treatment landscape for hemimegalencephaly and may support improved neurodevelopmental trajectories. Findings underscore the feasibility of early, minimally invasive strategies for managing medically refractory epilepsy in the high-risk population of young infants with refractory epilepsy secondary to hemimegalencephaly.

Indexed as

Drug Resistant EpilepsyEmbolization, TherapeuticHemimegalencephalyHemispherectomyFemaleHemodynamicsHumansInfantInfant, NewbornMaleSeizuresTreatment Outcome

Identifiers

PMID41028505

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.