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Pediatric Neurosurgery

Yuichiro Yoneoka, Junichi Yoshimura, Masayasu Okada, Yukihiko Fujii
We present a pediatric case of neurohypophyseal germinoma with a perifocal inflammatory reaction (PIR) with volume fluctuation caused by diagnostic radiation-induced regression (DRIR). On-target biopsy failed to confirm the histology because PIR hardly contained any germinoma cells. DRIR-related fluctuation of the tumor volume disguised germinoma as inflammation. We analyzed the cerebrospinal fluid (CSF) and detected a high level of placental alkaline phosphatase (PLAP), which demonstrated the neurohypophyseal lesion to be germinoma and brought the patient from successful radiochemotherapy up to complete remission...
November 11, 2016: Pediatric Neurosurgery
Erfanul Saker, Marios Loukas, Christian Fisahn, Rod J Oskouian, R Shane Tubbs
INTRODUCTION: Our appreciation and understanding of what is now known as the split cord malformation (SCM) have a long history. The oldest known example of SCM is from roughly AD 100. Other isolated examples can be found in the large body of work of the pathologists of the 1800s, where the SCMs were found incidentally during autopsies. CONCLUSIONS: SCM has a rich history and has intrigued physicians for over 200 years. Many well-known figures from the past such as Chiari and von Recklinghausen, both pathologists, made early postmortem descriptions of SCM...
2017: Pediatric Neurosurgery
Apinderpreet Singh, Ravi Garg, Kirti Gupta, Pravin Salunke
No abstract text is available yet for this article.
2017: Pediatric Neurosurgery
Sandeep Kandregula, Amey R Savardekar, B N Nandeesh, A Arivazhagan, Malla Bhaskar Rao
Giant hypothalamic hamartomas (GHH) are extremely rare lesions in infants and usually intrinsically epileptogenic. We present the case of a 10-month-old girl child presenting with drug-resistant seizures and a giant hypothalamic lesion that was confirmed as hamartoma on histopathology. Surgical decompression and disconnection from the hypothalamus was performed with the intent of controlling her seizures. Unfortunately, the patient developed right middle cerebral artery and posterior cerebral artery territory infarction, possibly due to vasospasm or thrombosis of the vessels...
2017: Pediatric Neurosurgery
Mika Ishige, Tatsuo Fuchigami, Erika Ogawa, Hiromi Usui, Ryutaro Kohira, Yoriko Watanabe, Shori Takahashi
Glutaric acidemia type 1 is a rare autosomal recessive disease caused by a deficiency of glutaryl-CoA dehydrogenase. Previous studies have reported subdural hemorrhage in untreated patients with glutaric acidemia type 1. However, there is only one report of severe acute subdural hemorrhage after minor head trauma in a patient with glutaric acidemia type 1 under guideline-recommended treatment. We report a second case of life-threatening severe acute subdural hemorrhage after a minor head trauma in a patient with glutaric acidemia type 1...
2017: Pediatric Neurosurgery
Joshua L Gu, Anthony Johnson, Marcia Kerr, Kenneth J Moise, Michael W Bebbington, Claudia Pedroza, David I Sandberg
BACKGROUND/AIMS: This study evaluates the predictive value of prenatal imaging measurements regarding the need for cerebrospinal fluid (CSF) diversion for fetal hydrocephalus in the first 3 months after birth. METHODS: We retrospectively reviewed a consecutive case series of patients with fetal hydrocephalus from January 2011 to December 2014 (n = 45). Prenatal measurements included head circumference (HC), biparietal diameter (BPD), and lateral ventricle (LV) width...
2017: Pediatric Neurosurgery
Tymon Skadorwa, Bogdan Ciszek
BACKGROUND/AIMS: Tumors of the cranial vault occur at every age of childhood. Although they are mostly benign lesions, their symptomatology is variable and requires extended diagnostics. The choice of therapeutic strategy strongly depends on histopathological diagnosis, and therefore surgical excision is the elective treatment in such cases. Despite several published papers, the literature still lacks reliable clinical characteristics regarding this heterogeneous group of lesions in pediatric patients...
2017: Pediatric Neurosurgery
Shivani D Rangwala, Daniel M Birk, Matthew K Tobin, Yoon S Hahn, Demetrios C Nikas
Nonaccidental head injury, as seen in domestic child abuse cases, is often associated with spinal injury, and spinal subdural hematoma is the most frequent diagnosis. While spinal epidural hematomas are a rare occurrence, the incidence of spontaneous epidural hematomas occurring in nonaccidental head injury patients is even lower. Epidural hematomas often result in acute focal neurological deficits necessitating emergent neurosurgical intervention. In patients without focal neurological deficits, conservative management may allow for spontaneous resolution of the epidural hematoma...
2017: Pediatric Neurosurgery
Nishanth Sadashiva, Satyakam Baruah, Shilpa Rao, Anita Mahadevan, Kannepalli Narasinga Rao, Vikas Vazhayil, Sampath Somanna
Intracranial Langerhans cell histiocytosis commonly presents as skull lesions in children. An intratumoral cyst with fluid level and epidural hematoma occurring with eosinophilic granuloma is very rare. We report a 15-year-old boy who presented with a spontaneous epidural hematoma which was the result of a temporal eosinophilic granuloma. Multiple explanations for epidural hematoma in such cases have been discussed. Intratumoral hemorrhage followed by cyst formation and rupture may explain the pathophysiology of epidural hemorrhage formation...
2017: Pediatric Neurosurgery
Kimberly A Foster, Asim Choudhri, Ryan Lingo, Frederick Boop
Melanotic neuroectodermal tumor of infancy (MNTI) is a rare lesion that typically manifests in the first year of life, most commonly involving the facial bones. We present 2 infants with MNTI involving the posterior skull with associated compression of the superior sagittal sinus (SSS). A review of the anatomical locations of MNTI is offered, and the implications of SSS involvement are described. This represents the first known description of MNTI with involvement of the posterior SSS.
2017: Pediatric Neurosurgery
Necati Ucler, Fatih Serhat Erol, Sait Ozturk, Bekir Akgun, Metin Kaplan, Yasar Sen
OBJECTIVE/AIM: The aim of this report was to investigate the effect of ventriculoperitoneal shunt insertion for the treatment of hydrocephalus on thyroid hormones in the first 3 months of life. METHODS: Thyroid-stimulating hormone (TSH), free T3 (fT3), and free T4 (fT4) levels were compared at 7 days (preoperatively) and at 30 and 90 days (postoperatively) after birth between 25 ventriculoperitoneal shunt-inserted hydrocephalic newborns and 20 healthy newborns. RESULTS: The TSH level at 7 days was higher in the hydrocephalic patient group (6...
2017: Pediatric Neurosurgery
Daniele Starnoni, Gopalakrishnan Chittur Viswanathan, Roy Thomas Daniel, Mattia Rizzi, Mahmoud Messerer
No abstract text is available yet for this article.
2017: Pediatric Neurosurgery
Dani O Gonzalez, Justin B Mahida, Lindsey Asti, Erica J Ambeba, Brian Kenney, Lance Governale, Katherine J Deans, Peter C Minneci
BACKGROUND: Ventriculoperitoneal (VP) shunt placement, the mainstay of treatment for hydrocephalus, can place a substantial burden on patients and health care systems because of high complication and revision rates. We aimed to identify factors associated with 30-day VP shunt failure in children undergoing either initial placement or revision. METHODS: VP shunt placements performed on patients in the 2012-2013 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Pediatric were identified...
2017: Pediatric Neurosurgery
Semra Işık, Akın Akakın, Murat Şakir Ekşi, Baran Yılmaz, Tamer Aksoy, Murat Konakçı, Zafer Orkun Toktaş, Türker Kılıç
Foot drop is an inability to dorsiflex the ankle and toe. Primary causes of foot drop are compression or lesion of the 5th lumbar nerve and entrapment of the peroneal nerve at the head of the fibula. Rarely, some central nervous system lesions lead to foot drop. A 16-year-old boy was admitted with blunt head trauma that had happened in an assault. The muscle strength of the bilateral tibialis anterior, bilateral extensor digitorum longus and bilateral extensor digitorum brevis were Medical Research Council grade 1...
2017: Pediatric Neurosurgery
Kerem Mazhar Ozsoy, Kadir Oktay, Yurdal Gezercan, Nuri Eralp Cetinalp, Semih Kivanc Olguner, Tahsin Erman
Cavernous malformations (CMs) of the central nervous system are benign, angiographically occult vascular lesions and are diagnosed by magnetic resonance imaging techniques. Giant CMs do not differ from smaller-sized CMs in their clinical, surgical or histopathological presentation but may be radiologically different. In this paper, we report a 10-year-old male with a giant CM of 8 × 7.5 × 7 cm in diameter that was completely removed by microsurgical treatment. This case addresses important points for practicing neurosurgeons to consider when making a differential diagnosis of large intracranial mass lesions in pediatric patients...
2017: Pediatric Neurosurgery
Deepasree Jaganmohan, Nagarajan Krishnan, Ramesh Ananthakrishnan, Gopan Gopalakrishna Pillai
The basioccipital skull base is an extremely rare site for meningoencephalocele. The herniation of the brainstem or part of it through a basioccipital defect is even rarer. We report a case of rhombencephalomeningocele associated with a tethered dermoid. An extensive literature search revealed no such case report of basioccipital cranial dysraphism so far presenting with cranial nerve palsy.
June 18, 2016: Pediatric Neurosurgery
Matthew R Reynolds, Devon H Haydon, John Caird, Jeffrey R Leonard
Minimizing normal-tissue radiation exposure is especially important in the pediatric population as children appear to be particularly sensitive to postradiation vasculopathies after conventional photon radiotherapy. Given the limited scattering effect and low-dose radiation delivery to the surrounding tissues with proton beam radiotherapy, this modality is considered to be an effective treatment for pediatric skull-base tumors compared to conventional radiotherapy, and to have fewer adverse side effects. We report 2 cases of radiation-induced moyamoya syndrome following proton beam therapy in pediatric patients...
May 19, 2016: Pediatric Neurosurgery
Alexander Drofa, Evgueni Kouznetsov, Stephen Tomek, Matthew Wiisanen, Michael Manchak, Timothy Lindley, Steven Mitchell, Ferdinand Hui, Dane Breker
Cerebral sinus venous thrombosis (CSVT) is a recognized cause of childhood and neonatal stroke. More than 50% of neonates have a poor outcome, and mortality is high. Coma is a predictor of death in neonatal CSVT. We present the case of a 9-day-old infant, who presented in coma and was treated successfully with a combination of mechanical thrombectomy using the MindFrame System via the right jugular vein, local infusion of recombinant tissue plasminogen activator and abciximab, as well as anticoagulation. In this case, aggressive thrombectomy and thrombolysis achieved complete neurologic restoration safely and quickly...
2016: Pediatric Neurosurgery
James Bales, Susan Apkon, Marisa Osorio, Gregory Kinney, R Aaron Robison, Erin Hooper, Samuel Browd
BACKGROUND/AIMS: Selective dorsal rhizotomy for spastic cerebral palsy is an effective and well-validated surgical approach. Multiple techniques have been described in the past including multiple laminectomies and a single-level laminectomy at the level of the conus. There is considerable technical challenge involved with a single-level laminectomy approach. METHODS: We report here a modification of the single-level laminectomy that selectively analyzes each individual nerve root with electromyography to separate dorsal and ventral nerve roots through comparison of stimulus responses...
2016: Pediatric Neurosurgery
Ivan Pašalić, Ines Trninić, Jakob Nemir, Hrvoje Jednačak, Kamelija Žarković, Goran Mrak
Angiofibromas are rare tumors of the head and neck that mostly occur in the sphenopalatine region. We present a case of angiofibroma in a young male patient with an unusual and extremely rare localization, which to our knowledge has not been described before. It was situated in the tentorium and spread to the supratentorial and infratentorial regions. The patient initially presented with symptoms of increased intracranial pressure. After a diagnostic evaluation was done, the whole tumor was successfully removed using the supratentorial and infratentorial approach and the microsurgical technique...
2016: Pediatric Neurosurgery
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