Hemispherotomy in a patient with intractable epilepsy also on anticoagulant therapy for coronary artery aneurysms secondary to Kawasaki disease - Proposal of an ethical approach

摘要

Purpose To describe the safe performance of epilepsy surgery in a patient on anticoagulant therapy. Patient and method An 11-year-old girl developed Kawasaki disease, which caused coronary artery aneurysms. She had a left middle cerebral artery area infarction, manifesting as intractable epilepsy. However, other medical facilities hesitated to perform the surgery due to the risks of vascular events as a result of stopping anticoagulant therapy. Results The patient was firm in their desire to have epilepsy surgery performed. We discontinued anticoagulants and performed left hemispherotomy. After the surgery, the patient was free of seizures without any complications. Highlights ? First case report of epilepsy surgery on a patient with Kawasaki disease ? Significant risks associated with treatment ? A patient who was on anticoagulants and to discuss the relevant clinical ethics.