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Pediatric Neurosurgery

Ajay Chatrath, Panagiotis Mastorakos, Gautam U Mehta, Miriam Wildeman, Shayan Moosa, John A Jane
BACKGROUND: Gangliogliomas are low-grade neoplasms that typically affect patients under the age of 30 and present with epilepsy and symptoms of mass effect. Here, we report a case of an intraventricular ganglioglioma involving the septum pellucidum in a pediatric patient with history of optic glioma. Only one other pediatric intraventricular ganglioglioma arising from the septum pellucidum has been reported previously. CASE REPORT: The patient initially presented at 9 months of age with a pilocytic astrocytoma centered on the optic chiasm, treated with chemotherapy and radiation at 3 years of age...
January 8, 2019: Pediatric Neurosurgery
Daryl C McHugh, Susan M Fiore, Nancy Strong, Michael R Egnor
BACKGROUND: We investigated a novel surgical approach to decompressive craniectomy (DC), the bifrontal biparietal, or "cruciate," craniectomy, in severe pediatric traumatic brain injury (TBI). Cruciate DC was designed with a fundamentally different approach to intracranial pressure (ICP) control compared to traditional DC. Cruciate DC involves craniectomies in all 4 skull quadrants. The sagittal and coronal bone struts are disarticulated at the skull to allow the decompression of the sagittal sinus and bridging veins in addition to permitting cerebral expansion, thereby maintaining cranial compliance...
January 3, 2019: Pediatric Neurosurgery
Alp Özgün Börcek, Ayfer Aslan
BACKGROUND: Chiari malformation type 1 (CM-1) is a generally congenital, rarely acquired disease characterized with 5 mm or more displacement of cerebellar tonsils through foramen magnum. METHODS: Here, we report about 2 patients with CM-1 progressed in the degree of tonsillar herniation from our clinic, whereas increasing in prolapse of tonsillar herniation after diagnosis is extremely uncommon. RESULTS: The first patient aged 17 years was diagnosed with CM-1 in 2009 and was operated due to progression of 5 mm radiologically and worsening symptoms in 2014...
December 21, 2018: Pediatric Neurosurgery
Erman Ataş, Ali Varan, Canan Akyüz, Nejat Akalan, Münevver Büyükpamukçu
No abstract text is available yet for this article.
December 13, 2018: Pediatric Neurosurgery
D Sylvain Zabsonre, Henri Lankoande, Chantal F C Zoungrana/Ouattara, Abdoulaye Thiombiano, Soumaila Ouedraogo, Abdoulaye Sanou, Pacome Yameogo, Sonia J E Kaboret-Douamba, Abel Kabre
BACKGROUND: Neural tube defects (spina bifidas or cephaloceles) are congenital malformations that can be associated with hydrocephalus. Even if the surgical management of each of these pathologies separately is well established, this is not the case for a combination of these conditions. AIM: To report our results of simultaneous or separate surgery for the association of hydrocephalus with neural tube defect in the same patient. METHODS: This was a retrospective study of the association of hydrocephalus with neural tube defect (spina bifida or cephalocele) managed over a period of 7 years at the Department of Neurosurgery, Yalgado Ouedraogo University Hospital, Ouagadougou, Burkina Faso...
December 5, 2018: Pediatric Neurosurgery
Felix Kiepe, Elvis Josef Hermann, Hans E Heissler, Helga Henseler, Peter M Vogt, Joachim K Krauss
We introduce a novel technique for the treatment of severe kyphosis in myelomeningocele. A 5-year-old paraplegic boy with myelomeningocele presented with severe thoracolumbar kyphosis and a chronic ulcus at the site of the gibbus. The myelomeningocele had been treated during his first week of life, and an accompanying Chiari type II malformation had been treated by ventriculoperitoneal shunting. He subsequently developed a rapidly progressive thoracolumbar kyphosis with an angle of 180° between T10 and L5...
November 27, 2018: Pediatric Neurosurgery
Luana Antunes Maranha Gatto, Thiago Ferreira Simões de Souza, Guilherme Naves de Lima Alves, Tayna Padilha Miranda, Gelson Luis Koppe, Zeferino Demartini
BACKGROUND: Dural arteriovenous fistula (DAVF) is rare in children. Development theories postulate a response to cerebral sinovenous thrombosis (CSVT) or to venous hypertension. The symptoms are highly nonspecific and depend on lesion location. Standard treatment of thrombosis is based on antithrombotic therapy, while the main therapy for DAVF is embolization. CASE REPORT: An 8-year-old boy presented with headache was diagnosed with CSVT and treated with anticoagulant...
November 27, 2018: Pediatric Neurosurgery
Albert Tu, Aaron Robison, Edward Melamed, Ian Buchanan, Omid Hariri, Harish Babu, Linda Szymanski, Mark Krieger
BACKGROUND/AIMS: Pilocytic astrocytomas are common pediatric tumors. Molecular profiles vary with location of origin. Comparisons of proliferation have not been reported. We sought to identify differences in growth by region and whether these predict clinical behavior. METHODS: A retrospective review of all patients undergoing surgery for a pilocytic astrocytoma at Children's Hospital LA from 2003 to 2015 was completed. Tumor location, determined by imaging, was stratified into infratentorial, supratentorial, or optic pathway...
November 14, 2018: Pediatric Neurosurgery
Serdar Ercan, Ebru Guzel, Aslan Guzel
Tethered cord syndrome (TCS), a neurological disorder characterized by the lower settlement of the conus medullaris, is a congenital spinal disease which is caused by split cord syndrome, meningomyelocele, and spinal tumors. Cranial dermoid tumor (CDT) is a congenital benign tumor which is generally located on the midline of the cranium. Even though TCS is highly associated with spinal dermoid tumor, the relationship of CDT and TCS is unusual. We pre-sent a case with an unusual symptom of CDT, motion-dependent pain, and an uncommon togetherness with TCS...
November 8, 2018: Pediatric Neurosurgery
Binod Balakrishnan, Liyun Zhang, Pippa M Simpson, Sheila J Hanson
BACKGROUND: Severe traumatic brain injury (sTBI) is the leading cause of morbidity and mortality from trauma. Brain Trauma Foundation guidelines recommend intracranial pressure (ICP) monitoring in sTBI. We hypothesized that early ICP monitor placement was associated with better outcomes in children. METHODS: This was a retrospective study of children with sTBI admitted to the participating pediatric intensive care units (PICUs) and entered into the Virtual Pediatric Systems (VPS), LLC, database between 1 January 2010 and 31 December 2015...
November 7, 2018: Pediatric Neurosurgery
Nobuya Murakami, Takato Morioka, Takafumi Shimogawa, Nobutaka Mukae, Satoshi Inoha, Takakazu Sasaguri, Satoshi O Suzuki, Koji Iihara
BACKGROUND: An ependyma-lined canal with surrounding neuroglial tissues can be present in lumbosacral lipomatous malformations; however, the precise embryological significance is still unclear. METHOD: Six out of 50 patients with lipomatous malformations had ependymal structures. We retrospectively analyzed the clinical, neuroradiological, and histological findings of these patients to demonstrate the relationship with the embryological background of the retained medullary cord (RMC), which normally regresses, but was retained here because of late arrest of secondary neurulation...
November 2, 2018: Pediatric Neurosurgery
Zeferino Demartini, Luana A M Gatto, Roberto Oliver Lages, Alexandre Novicki Francisco, Adriano Keijiro Maeda, Gelson Luis Koppe
PHACE(S) syndrome is a neurocutaneous syndrome with a wide array of presentations. The most known and present trait is facial hemangioma > 5 cm. The name is an acronym for Posterior fossa malformations, infantile Hemangiomas, Arterial anomalies, aortic Coarctation, Eye abnormalities, and middle-line malformations of the Sternum. The exact etiopathogenic mechanism of this syndrome is not fully understood, and its treatment depends on detailed and individualized assessment. The aim of this paper is to describe a child with a throat hemangioma, vascular malformations, cognitive delay, and other anomalies to illustrate the neuroimaging found in this syndrome...
October 18, 2018: Pediatric Neurosurgery
Mehmet Can Ezgu, Mehmet Ilker Ozer, Adem Dogan, Guzin Deveci, Cahit Kural, Yusuf Izci
Lhermitte-Duclos disease (LDD) is a rare, slow-growing, benign lesion of the cerebellum. It is often seen in the second and fourth decades. This disease is extremely rare in childhood. A 6-year-old girl presented with loss of balance. A mass lesion in the right cerebellum was detected by magnetic resonance imaging. The patient underwent surgical removal of the lesion, and the histological diagnosis was dysplastic gangliocytoma (LDD). The patient was discharged without complication, and her balance improved in the follow-up period...
October 10, 2018: Pediatric Neurosurgery
Pinar Aydin Ozturk, Omer Sanri, Adil Yilmaz, Abdurrahman Arpa, Unal Ozturk, Adnan Ceviz
Factor XIII deficiency is a rare hemorrhagic disorder that can cause spontaneous intracranial hemorrhage and bleeding after surgery. The diagnosis of factor XIII deficiency is difficult before surgical interventions, because coagulation parameters are normal in these patients. Important clinical findings are postsurgical bleeding and recurrent spontaneous intracranial hematomas. These findings should raise the clinical suspicion of factor XIII deficiency. Therefore, diagnosis of factor XIII deficiency is very important for neurologists and neurosurgeons in terms of reducing mortality and morbidity...
September 3, 2018: Pediatric Neurosurgery
Yusuke S Hori, Keina Nagakita, Yuki Ebisudani, Mizuho Aoi, Yoko Shinno, Toru Fukuhara
Choroid plexus hyperplasia/papilloma and resulting hyperproduction of cerebrospinal fluid is a rare cause of hydrocephalus. In these patients, intractable ascites can occur after a ventriculoperitoneal (VP) shunting operation. However, shunt-related hydrocele is a rare complication of VP shunting. Previous reports have indicated catheter-tip migration to the scrotum as a cause of hydrocele. Here, we present the first documented case of choroid plexus hyperplasia that led to intractable ascites after shunting and a resulting hydrocele without catheter-tip migration into the scrotum...
August 29, 2018: Pediatric Neurosurgery
Li-Rong Cao, Jing Chen, Rui-Ping Zhang, Xiao-Li Hu, Yu-Lian Fang, Chun-Quan Cai
Choroid plexus papilloma (CPP) is a rare benign tumor of the central nervous system. Bilateral lateral ventricle CPP is extremely uncommon. In this case report, we described a case of bilateral lateral ventricle CPP in a 4-month-old female patient conceived by in vitro fertilization (IVF). Neurological examination and imaging were performed. In neurological examination, meningeal irritation signs and sunset phenomenon were positive. Brain computed tomography (CT) and magnetic resonance imaging (MRI) displayed masses located in the trigone of the bilateral lateral ventricle with hydrocephalus...
2018: Pediatric Neurosurgery
Maureen Lacy, Samantha DeDios-Stern, Sarah Fredrickson, Shravan Parikh, Todd Nader, David M Frim
This cross-sectional study investigates the prevalence and risks for psychiatric diagnoses in a large cohort of children with Chiari malformation type 1 (CM1) presenting for neurosurgical evaluation. Children between the ages of 6 and 17 years who were evaluated and diagnosed with CM1 at a neurosurgery clinic were identified. Eighty-six participants were recruited for this study with an average age of 11 years. Parents of participants completed a pediatric medical history questionnaire and a semistructured interview regarding the child's psychiatric, developmental, medical, and family history...
2018: Pediatric Neurosurgery
Zeferino Demartini, Luana Antunes Maranha Gatto, Tatiane Coghetto da Rocha, Adriano Keijiro Maeda, Adriana Valerio, Gelson Luis Koppe, Alexandre Novicki Francisco
Intracranial aneurysm surgery is commonly performed using pinned head holders, which pose a higher risk for the pediatric population. Several authors recommend avoiding the use of this device when it is not strictly necessary, and this is currently possible considering advances in anesthesiology and monitoring. As the literature on microsurgery without skull clamp use is scant, we report the case of a 15-year-old boy presenting with a subarachnoid hemorrhage after rupture of a middle cerebral artery aneurysm...
2018: Pediatric Neurosurgery
Thao N Do, Amy M Linabery, Richard J Patterson, Albert Tu
BACKGROUND: Rhabdomyosarcoma originating in the mastoid is rare and may be misdiagnosed as an infectious mastoiditis due to overlapping clinical and imaging features. We aimed to identify distinguishing characteristics to facilitate earlier diagnosis and treatment. METHOD: Here we describe a case report and a systematic review of 23 reports describing previous cases of mastoid rhabdomyosarcoma. We compare these patients to a systematic review of patients with infectious mastoiditis and identify distinguishing clinical features...
2018: Pediatric Neurosurgery
Valentina Baro, Luca Denaro, Domenico d'Avella
PURPOSE: We report our preliminary experience concerning the use of thrombin-gelatin hemostatic matrix to strengthen the final hemostasis after posterior fossa low-grade tumor surgery in children. To our knowledge, this is the first report regarding the use of hemostatic matrix in pediatric neurosurgery. MATERIALS AND METHODS: Between 2012 and 2016, twenty-three patients underwent posterior fossa surgery for low-grade gliomas in our department. The mean age was 6...
2018: Pediatric Neurosurgery
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